Takawira Farirai, Ayer Julian G, Onikul Ella, Hawker Richard E, Kemp Allan, Nicholson Ian A, Sholler Gary F
The Adolph Basser Cardiac Institute, The Children's Hospital at Westmead, Sydney, Australia.
Heart Lung Circ. 2008 Oct;17(5):407-10. doi: 10.1016/j.hlc.2008.01.001. Epub 2008 Apr 9.
The prevalence of thrombosis after the Fontan procedure depends upon the surgical technique used and the method of detection employed. Current investigations for thrombosis lack sensitivity and specificity or, in the paediatric population, require a general anaesthetic. We undertook a study to examine the feasibility of using magnetic resonance imaging (MRI) to detect thrombosis within the conduit, cardiac chambers and pulmonary arteries after the extracardiac conduit modification of the Fontan procedure.
Of the 50 children who had undergone this procedure at our institution between 1997 and 2002, 26 were eligible for, and 13 underwent, MRI study. The mean age was 10.2 years (range 8.2-16.8 years, median 9.5 years) and the average time from operation was 63 months (range 29-79 months, median 68 months). The mean age at Fontan operation was 4.9 years (range 2.1-10.5 years). Ten were on low dose aspirin, two were on warfarin and one was not anti-coagulated. In all cases, satisfactory imaging of the venous pathways and pulmonary arteries was obtained and there were no thrombi detected.
We conclude that MRI is a potentially useful tool for the detection of thrombus in patients who have undergone the Fontan operation.
Fontan手术（全腔静脉-肺动脉连接术）后血栓形成的发生率取决于所采用的手术技术和检测方法。目前用于血栓形成的检查缺乏敏感性和特异性，或者在儿科人群中需要全身麻醉。我们进行了一项研究，以检验使用磁共振成像（MRI）检测在Fontan手术进行心外管道改良术后管道、心腔和肺动脉内血栓形成的可行性。
在1997年至2002年间于我院接受该手术的50名儿童中，26名符合条件，13名接受了MRI检查。平均年龄为10.2岁（范围8.2 - 16.8岁，中位数9.5岁），距手术的平均时间为63个月（范围29 - 79个月，中位数68个月）。Fontan手术时的平均年龄为4.9岁（范围2.1 - 10.5岁）。10名患儿服用低剂量阿司匹林，2名服用华法林，1名未进行抗凝治疗。在所有病例中，均获得了静脉通路和肺动脉的满意成像，未检测到血栓。
我们得出结论，MRI对于检测接受Fontan手术患者的血栓是一种潜在有用的工具。
