ArticleJournal of the American Heart Association2025
Discordances in Kinetic Energy Between the Superior Cavopulmonary Connection and Single Ventricle Are Associated With Suboptimal Fontan Outcomes: A Pre-Fontan 4-Dimensional Flow Study.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Altered caval flow and wall shear stress in single ventricle circulation: insights from ferumoxytol-enhanced 4D flow MRI.European heart journal. Imaging methods and practice · 2026Article
- Longitudinal Intracardiac Right Ventricular Flow Analysis in Infants With Hypoplastic Left Heart Syndrome in Interstage I Using Novel Doppler Velocity Reconstruction.Journal of the American Heart Association · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with functional single ventricle (SV) are at risk for adverse outcomes after staged palliation from the superior cavopulmonary connection (SCPC) to the Fontan. Current pre-Fontan assessment by cardiac magnetic resonance and cardiac catheterization includes measuring atrioventricular valve regurgitation, aortopulmonary collateral burden, and pressures. Four-dimensional flow can quantify complex flows representing hemodynamic inefficiency. This study determined the clinical significance of kinetic energy (KE) and viscous energy loss in patients before the Fontan procedure using 4-dimensional flow. METHODS AND
resultsThis was a retrospective analysis of patients before the Fontan procedure who underwent ferumoxytol-enhanced cardiac magnetic resonance and same-day catheterization. Four-dimensional flow data sets were analyzed using ITFlow (CardioFlowDesign) to measure KE/viscous energy loss in the atrium, SV, and SCPC. A composite outcome was defined by rejected Fontan candidacy, prolonged hospitalization, lymphatic dysfunction, or heart failure. The relationship between these outcomes and KE/viscous energy loss was assessed by bivariable and multivariable logistic regression analyses as appropriate. Sixty-five patients (3.9±1.5 years, 0.64±0.1 m
conclusionsFour-dimensional flow analysis provides insight into SV hemodynamics and is associated with short-term outcomes. Future work will analyze the longitudinal implications for patients undergoing the Fontan procedure.
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