Cardiac catheterization also provides an opportunity for interventional procedures before the Fontan operation consisted of embolization of aortopulmonary collateral vessels [45]. Other important indications for cardiac catheterization include severe atrioventricular valve regurgitation semiquantitatively evaluated by means of echo color Doppler, suspected pulmonary vein stenosis at echo or CMR, suspected pulmonary pathway or Glenn anastomosis obstruction, or suspected significant venovenous collaterals at MRA [46]. Arteriography Pulmonary Pulmonary arteriography is performed after echocardiography when there is a suspicion of branch pulmonary artery stenosis because smaller pulmonary arteries are not optimally seen on echocardiography. CTA Chest Pulmonary embolism and thrombosis are known complications in patients undergoing single ventricle palliation. CTA is an effective method for diagnosis of pulmonary embolism in patients presenting with symptoms suspicious for pulmonary embolism [48]. CTA Coronary Arteries There is no relevant literature to support the use of CTA coronary arteries in the evaluation of known single ventricle physiology. MRI Heart Function and Morphology Routine preoperative imaging before Fontan procedure is obtained using CMR for anatomy and to determine the current hemodynamics and physiology [49,50]. CMR is a comprehensive modality for accurate assessment of ventricular function, pulmonary artery, pulmonary venous return, cavopulmonary anastomosis, aortic arch, valves, and any valvular regurgitation. Congenital or Acquired Heart Disease MRA Chest MRA chest provides good assessment of branch pulmonary arteries, their caliber, and presence of thrombus within but often fails to visualize very small aortopulmonary collaterals that may require preoperative embolization. MRA Neck There is no relevant literature to support the use of MRA neck in the evaluation of known single ventricle physiology.
Congenital or Acquired Heart Disease. Cardiac catheterization also provides an opportunity for interventional procedures before the Fontan operation consisted of embolization of aortopulmonary collateral vessels [45]. Other important indications for cardiac catheterization include severe atrioventricular valve regurgitation semiquantitatively evaluated by means of echo color Doppler, suspected pulmonary vein stenosis at echo or CMR, suspected pulmonary pathway or Glenn anastomosis obstruction, or suspected significant venovenous collaterals at MRA [46]. Arteriography Pulmonary Pulmonary arteriography is performed after echocardiography when there is a suspicion of branch pulmonary artery stenosis because smaller pulmonary arteries are not optimally seen on echocardiography. CTA Chest Pulmonary embolism and thrombosis are known complications in patients undergoing single ventricle palliation. CTA is an effective method for diagnosis of pulmonary embolism in patients presenting with symptoms suspicious for pulmonary embolism [48]. CTA Coronary Arteries There is no relevant literature to support the use of CTA coronary arteries in the evaluation of known single ventricle physiology. MRI Heart Function and Morphology Routine preoperative imaging before Fontan procedure is obtained using CMR for anatomy and to determine the current hemodynamics and physiology [49,50]. CMR is a comprehensive modality for accurate assessment of ventricular function, pulmonary artery, pulmonary venous return, cavopulmonary anastomosis, aortic arch, valves, and any valvular regurgitation. Congenital or Acquired Heart Disease MRA Chest MRA chest provides good assessment of branch pulmonary arteries, their caliber, and presence of thrombus within but often fails to visualize very small aortopulmonary collaterals that may require preoperative embolization. MRA Neck There is no relevant literature to support the use of MRA neck in the evaluation of known single ventricle physiology.