Value of magnetic resonance imaging (MRI) for the assessment of ventricular and anastomosis function in patients with extra- or intracardial total cavopulmonary connection (TCPC)-modified Fontan-Operation.

Purpose: To evaluate different MR methods (ventricle and flow measurements) for the postoperative follow-up of hemodynamics in patients with extra- or intracardial TCPC. Materials and Methods: Twenty-eight consecutive patient s (14 female, 14 male) within the ages of two to thirty-eight years were ex amined using a 1.5 T Gyro-scan ACS-NT scanner (Philips, Best, Netherlands). 7 patients had an extracardial (eTCPC), and 21 an intracardial (iTCPC) tun nel. The calculation of the ventricular function and muscle mass was perfor med using "multislice-multiphase" technique by summing up the enddiastolic and endsystolic areas; the flow measurements were evaluated by phase shift velocity mapping in the superior vena cava (SVC), inferior vena cava (IVC), right (RPA) and left (LPA) pulmonary artery. Besides peak and mean velocit y, the mean and maximal flow volumes (ml/min) were calculated. Results: Eje ction fraction (EF) of the functionally single ventricle was within the nor mal range (mean 57%) in 22/28 patients while mean muscle mass was elevated in the group with eTCPC (mean 121 g/m(2)). The mean flow volumes and the pe ak velocities in all vessels were higher in the group with iTCPC as compare d to the one with eTCPC. Clinically relevant retrograde flows in the IVC we re only found in the group with iTCPC (7/21), as well as a significant pred ominant flow distribution towards the RPA (p<0.05; Wilcoxon signed-rank tes t); in the group with eTCPC towards the LPA (n. s.). Conclusions: MRI is a useful method for the assessment of ventricular function and muscle mass in the follow-up after the modified Fontan Operation. MRI flow measurements a dditionally provided clinically relevant information about the hemodynamics in Fontan patients.