Page 73 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
96. Figure 2.
gadolinium-filled balloon inflated in the right/pulmonary venous atrium and then pulled back to perform FFTO. Hemodynamics were repeated after 10 minutes of occlu- sion. A decision for FFDC is made based on iCMR-derived hemodynamics.
Results: Thirteen Fontan patients underwent iCMR evalu- ation at our institution between January 2018 to January 2019. Median age and weight were 8.3yrs and 25.3kg, respectively (range: 5-33yrs and 16.4-80kg). Of the 13 Fontan patients who underwent PLE/cyanosis evaluation 9 were fenestrated and 4 non-fenestrated. The MRWire was successfully used to cross the Fontan fenestration in all 6 attempted patients.
Real-time MRI-guided RHC (n = 6), LHC/aortic pull back (n = 6), and FFTO (successful, n = 5; not tolerated, n =1) was successfully performed in the majority of patients when
the MRWire was used. An atrial arrhythmia complication was encountered in one patient after Fontan fenestration crossing with the wire that required cardioversion with no other complications. Time taken for first pass RHC, LHC/ aortic pull back, and crossing a Fontan fenestration was 5.2, 3.2, and 6.1 minutes, respectively. Patients were transferred to the fluoroscopy lab if further intervention was required including FFDC, balloon angioplasty, and/or coiling of col- laterals when indicated.
Conclusions: The feasibility and safety of performing Fontan pathway including FFTO evaluation in the iCMR suite has been established. These cases describe a more critical evaluation of Fontan pressures and cardiac output before FFDC by using accurate flow and cardiac output measurements from real-time MRI with simultaneous cath- eter based pressure measurements.
Hijazi, Z
22nd Annual PICS/AICS Meeting