SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of SPECT or SPECT/CT MPI rest and stress in the evaluation of known single ventricle physiology. Congenital or Acquired Heart Disease FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT heart in the evaluation of known single ventricle physiology. US Echocardiography Transesophageal TEE may provide useful information before, during, or after surgery for stage 2 palliation regarding pulmonary arterial or pulmonary venous flow patterns, severity of atrioventricular valve regurgitation, atrial shunt, and cardiac thrombus. Variant 6: Child. Known single ventricle physiology. Preoperative evaluation for stage 3 single ventricle palliation (total cavopulmonary connection). Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study. The Fontan operation for single ventricle patients is the procedure in which a conduit (the total cavopulmonary connection) is placed to channel the remaining systemic venous return (including the hepatic veins) into the pulmonary arteries. The aim of the diagnostic evaluation before Fontan is to identify those few patients in whom the Fontan operation should not be performed and those who require additional intervention before or at the time of Fontan. The main consideration before Fontan procedure is elevated pulmonary artery pressure, which determines the prognosis during the postoperative course. However, with the modern stage 2 repair techniques, pulmonary resistance is seldom an important issue at the pre-Fontan stage. Arteriography Coronary with Ventriculography Cardiac catheterizations are done when elevated pulmonary artery pressure or elevated ventricular filling pressure is suspected.
Congenital or Acquired Heart Disease. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of SPECT or SPECT/CT MPI rest and stress in the evaluation of known single ventricle physiology. Congenital or Acquired Heart Disease FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT heart in the evaluation of known single ventricle physiology. US Echocardiography Transesophageal TEE may provide useful information before, during, or after surgery for stage 2 palliation regarding pulmonary arterial or pulmonary venous flow patterns, severity of atrioventricular valve regurgitation, atrial shunt, and cardiac thrombus. Variant 6: Child. Known single ventricle physiology. Preoperative evaluation for stage 3 single ventricle palliation (total cavopulmonary connection). Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study. The Fontan operation for single ventricle patients is the procedure in which a conduit (the total cavopulmonary connection) is placed to channel the remaining systemic venous return (including the hepatic veins) into the pulmonary arteries. The aim of the diagnostic evaluation before Fontan is to identify those few patients in whom the Fontan operation should not be performed and those who require additional intervention before or at the time of Fontan. The main consideration before Fontan procedure is elevated pulmonary artery pressure, which determines the prognosis during the postoperative course. However, with the modern stage 2 repair techniques, pulmonary resistance is seldom an important issue at the pre-Fontan stage. Arteriography Coronary with Ventriculography Cardiac catheterizations are done when elevated pulmonary artery pressure or elevated ventricular filling pressure is suspected.