Document Detail

Myocardial perfusion and coronary flow reserve assessed by positron emission tomography in patients after Fontan-like operations.
MedLine Citation:
PMID:  12545320     Owner:  NLM     Status:  MEDLINE    
Ventricular dysfunction in patients after Fontan-like operations (FLOs) is a serious complication that might contribute to poor long-term results. Ischemic heart disease will have debilitating consequences on a Fontan heart. Ten patients (15.8 +/- 5.01 years) after FLO had transesophageal echocardiography and cardiac catheterization 9.3 +/- 4.2 years after surgery. Myocardial perfusion was assessed by NH3-positron emission tomography (rest/adenosine) and compared with that of 10 healthy adults (26.1 +/- 6.3 years). Ventricular function was normal in 4 and reduced in 6 patients; end systolic and end diastolic meridional wall stress was significantly elevated in the FLO group. Coronary angiography revealed no stenosis of the coronaries. Compared to normals, myocardial blood flow (MBF) at rest was higher in the FLO group (0.99 +/- 0.25 vs 0.77 +/- 0.17 ml/g/min, p <0.05), whereas MBF after vasodilatation (2.12 +/- 0.78 vs 3.10 +/- 0.85 ml/g/min, p <0.05) and coronary flow reserve (CFR) was reduced (2.5 +/- 0.88 vs 4.1 +/- 1.01, p <0.05), especially in those with impaired ventricular function. Coronary vascular resistance after vasodilatation was elevated in the FLO group (38.2 +/- 17.4 vs 24.5 +/- 8.3 mmHg/ml/g/min, p <0.05). Altered MBF, increased meridional wall stress, and impaired CFR are common findings in FLO. Attenuated CFR and reduced ventricular function are significantly correlated and may be risk factors for the long-term outcome.
M Hauser; F M Bengel; A Kühn; U Sauer; S G Nekolla; A Eicken; M Schwaiger; J Hess
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2003-01-28
Journal Detail:
Title:  Pediatric cardiology     Volume:  24     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-07-04     Completed Date:  2003-11-20     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-92     Citation Subset:  IM    
Deutsches Herzzentrum München, Pediatric Cardiology, Lazarettstrasse 36, 80636 Munich, Germany.
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MeSH Terms
Blood Flow Velocity
Case-Control Studies
Cohort Studies
Coronary Angiography
Coronary Circulation / physiology
Echocardiography, Transesophageal
Follow-Up Studies
Fontan Procedure / adverse effects,  methods*
Heart Catheterization
Heart Function Tests
Hemodynamics / physiology
Myocardial Ischemia / etiology,  radionuclide imaging*
Reference Values
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Statistics, Nonparametric
Tomography, Emission-Computed*
Tricuspid Atresia / surgery
Ventricular Dysfunction, Left / physiopathology,  radionuclide imaging*

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