Abstract #3223

Energy-loss in Fontan Circulation Develops Heterogeneous Pulmonary Perfusion: Hybrid Analysis of 2D Vortex Flow Map and 4D Flow MRI

Michinobu Nagao¹, Umiko Ishizaki¹, Yumi Shiina², Kenji Fukushima¹, Yuka Matsuo¹, Tatsunori Takahashi³, Kei Inai², In-Sam Park³, Yasuhiro Goto⁴, Yamato Shimomiya⁵, Yuzo Yamasaki⁶, Ichiro Sakamoto⁷, Kenichiro Yamamura⁸, Atsushi Takemura⁹, Masami Yoneyama⁹, and Shuji Sakai¹

¹Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan, ²Clinical Reserch for ACHD, Tokyo Women's Medical University, ³Pediatric Cardiology, Tokyo Women's Medical University, ⁴Radiological service, Tokyo Women's Medical University, ⁵Clinical Application Development Marketing Division, Ziosoft Inc, ⁶Clinical Radiology, Kyushu University, ⁷Cardiovascular Medicine, Kyushu University, ⁸Pediatrics, Kyushu University, ⁹Philips Electronics Japan

Patients with Fontan-operation, single-ventricle heart frequent have systematic collaterals that increase pulmonary blood flow. The competitive flow elevates pulmonary artery pressure, a process leading to erosion of flow energy. We developed a novel post-processing of 2D cine MRI named for “vortex flow map” to evaluate the energy-loss in Fontan-circuit. Vortex flow map shows energy-loss as small magnitude of vortex flow (MVF) and reveals the relation to heterogeneous pulmonary perfusion. In total cavopulmonary conversion, 4D flow can visualize energy-loss caused by a meandering extra-cardiac conduit and the conflict flow, leading to reduce unilateral lung perfusion.

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