ArticleEuropean heart journal. Imaging methods and practice2026
Altered caval flow and wall shear stress in single ventricle circulation: insights from ferumoxytol-enhanced 4D flow MRI.
Article in European heart journal. Imaging methods and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: Patients with single ventricle (SV) congenital heart disease typically undergo surgical palliation that reroutes the superior/inferior vena cava (SVC/IVC) directly to the pulmonary arteries, which alters vascular flow dynamics. Four-dimensional flow (4DF) cardiovascular magnetic resonance (CMR), particularly with ferumoxytol contrast, enables comprehensive assessment of flow distribution and wall shear stress (WSS) in small paediatric vessels. This study aimed to evaluate the differences in caval flow and WSS between SV and BiV patients. Methods and results: We retrospectively analysed patients who underwent clinically indicated ferumoxytol-enhanced (FE) 4DF CMR between 2019 and 2024. Patients with anomalous systemic or pulmonary venous return were excluded. 4DF data were evaluated on the cloud-based Tempus platform. Flow in the SVC, IVC, aorta, and descending aorta was quantified and indexed to the body surface area. The average WSS over time was measured. Among 387 patients ( Conclusion: SV physiology is associated with lower SVC flow and WSS independent of age or body size, suggesting altered systemic venous return intrinsic to cavopulmonary circulation. 4DF CMR is a valuable tool for assessing and monitoring systemic venous physiology in congenital heart disease.
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