Division of Cardiology, Loma Linda University Health, Loma Linda, CA, USA.
Division of Cardiology, University of California San Francisco, San Francisco, CA, USA.
Echocardiography. 2020 Dec;37(12):2222-2230. doi: 10.1111/echo.14819.
Recent advances in surgical techniques and perioperative care for patients with single ventricle physiology have led to a remarkable improvement in long-term survival, such that now the majority of patients with single ventricle physiology are living to adulthood after Fontan palliation. The management of adult patients with Fontan physiology is one of the most challenging clinical dilemmas encountered in contemporary cardiology. The complex and heterogeneous anatomical and physiological abnormalities seen in Fontan patients mandate that any clinical evaluation, either for routine follow-up or preoperative evaluation prior to any transcatheter or surgical intervention, incorporates detailed information from a careful and thorough echocardiographic examination, These examinations, however, can be complex and confusing, even for experienced echocardiographers. Ideally, the interpretation of these studies is informed by an understanding of the basic anatomical lesions and of the potential long-term complications encountered in adult single ventricle patients. In this review, we present a practical and clinically oriented approach to the echocardiographic evaluation of adult patients with single ventricle physiology post-Fontan.
近年来，单一心室生理学患者的手术技术和围手术期护理的进步，使得大多数单一心室生理学患者在 Fontan 姑息术后能够长期生存并成年。Fontan 生理学患者的成人管理是当代心脏病学中遇到的最具挑战性的临床难题之一。Fontan 患者的复杂和异质的解剖和生理异常，要求任何临床评估，无论是常规随访还是任何经导管或手术干预前的术前评估，都要结合详细的信息，来自仔细和彻底的超声心动图检查，然而，即使对于有经验的超声心动图医师来说，这些检查也可能很复杂和令人困惑。理想情况下，这些研究的解释是基于对基本解剖病变的理解和对成人单心室患者中遇到的潜在长期并发症的理解。在这篇综述中，我们提出了一种实用的、以临床为导向的方法，用于评估 Fontan 后单一心室生理学的成年患者的超声心动图。
