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CLINICAL RESEARCH: CONGENITAL HEART DISEASE

Hearts late after fontan operation have normal mass, normal volume, and reduced systolic function

A magnetic resonance imaging study

Andreas Eicken, MD^*,*, Sohrab Fratz, MD^*, Christine Gutfried, MD^*, Gunter Balling, MD^*, Markus Schwaiger, PhD, Rüdiger Lange, PhD, Raymonde Busch, MS, John Hess, PhD^* and Heiko Stern, PhD^*

^* Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum, Technische Universität, München, Germany
Department of Nuclear Medicine, Technische Universität, München, Germany
Department of Thoracic and Cardiovascular Surgery, Deutsches Herzzentrum, Technische Universität, München, Germany
Institute of Medical Statistics and Epidemiology, Technische Universität, München, Germany

Manuscript received March 7, 2003; revised manuscript received May 17, 2003, accepted June 13, 2003.

^* Reprint requests and correspondence: Dr. Andreas Eicken, Deutsches Herzzentrum, München, Lazarettstr. 36, D-80636 München, Germany.
eicken{at}dhm.mhn.de

OBJECTIVES: The purpose of this study was to assess ventricular mass, volume, and systolic function in patients late after Fontan operation by cardiac magnetic resonance imaging.

BACKGROUND: An assessment of determinants for ventricular function in post-Fontan patients was intended.

METHODS: Twenty-three unselected patients (9 female, 14 male) at a median age of 19.4 years (range, 7.8 to 31.3 years), at a median time of 10.5 years (range, 4.1 to 18 years) after Fontan operation were studied. A standard 1.5-T scanner was used, and analysis was performed using dedicated software. Ten healthy volunteers (median age 26.4, range 18 to 39.3 years) served as the control group.

RESULTS: Median end-systolic mass index was 72.2 g/m² (range, 43 to 138 g/m²) and 86.6 g/m² (range, 52 to 123 g/m²) in the control group (p = NS). Median end-diastolic ventricular volume was 64 ml/m² (range, 32 to 117 ml/m²) compared with 67.7 ml/m² (range, 59 to 75 ml/m²) in the control group (p = NS). Median ejection fraction was 49.3% (range, 20% to 63%) compared with 64.8% (range, 57% to 79%) in normals (p = 0.00001).

CONCLUSIONS: We conclude that long-term survivors of a Fontan operation have normal ventricular mass, normal volume, but reduced systolic ventricular function.

Abbreviations and Acronyms   BSA   body surface area   EF   ejection fraction   MRI   magnetic resonance imaging

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