McLennan Daniel, Schäfer Michal, Mitchell Max B, Morgan Gareth J, Ivy Dunbar, Barker Alex J, Jacobsen Roni
Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, 80045-2560, USA.
Section of Congenital Heart Surgery, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
Pediatr Cardiol. 2019 Jun;40(5):1093-1096. doi: 10.1007/s00246-019-02101-7. Epub 2019 Apr 13.
We report a case of a 23-year-old male with failing Fontan circulation who was taken to the catheterization lab to better evaluate the Fontan circulation and hemodynamics. Catheterization revealed arteriovenous malformations exclusively present in the right lung leading to the consideration of placing stents to direct the inferior vena cava flow through the Fontan circuit to the right pulmonary artery (RPA), thus increasing the RPA concentration of the hepatic factor. However, comprehensive 4D-Flow MRI analyses indicated sufficient distribution of the hepatic flow between branch pulmonary arteries, and consequently no further invasive intervention to redirect hepatic flow was performed.
我们报告了一例23岁患有功能性Fontan循环衰竭的男性病例，该患者被送往心导管实验室以更好地评估Fontan循环和血流动力学。心导管检查发现动静脉畸形仅存在于右肺，这促使考虑放置支架，以引导下腔静脉血流通过Fontan循环进入右肺动脉（RPA），从而提高肝因子在RPA中的浓度。然而，全面的4D血流磁共振成像分析表明，肝血流在肺叶动脉之间分布充足，因此未进行进一步的侵入性干预来重新引导肝血流。
