Abstract #4978

Fontan Patients Exhibit Altered CBF and ATT Measurements in Gray and White Matter: an ASL Study.

Emma Carpenter¹, Clio González-Zacarías^1,2, Sneha Verma¹, Jian Shen^1,3, Botian Xu^1,3, Soyoung Choi⁴, Silvie Suriany¹, Koen Baas⁵, Anand Joshi², Richard Leahy², Peter Chiarelli⁶, and John Wood^1,7

¹Cardiology, Children's Hospital Los Angeles, Los Angeles, CA, United States, ²Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California Viterbi School of Engineering, Los Angeles, CA, United States, ³Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, United States, ⁴Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States, ⁵Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands, ⁶Pediatric Neurosurgery, Children's Hospital Los Angeles, Los Angeles, CA, United States, ⁷Pediatrics CHLA, Keck School of Medicine of USC, Los Angeles, CA, United States

Synopsis

Keywords: Blood Vessels, Arterial spin labelling, Fontan, CBF, ATT, Oxygen Delivery

Motivation: Patients with Fontan palliation of single ventricular heart disease have significant cognitive deficits that may result from their chronically low cardiac output.

Goal(s): To determine whether global and regional brain oxygen delivery is normal in young adults after Fontan palliation.

Approach: We measured cerebral blood flow (CBF) and arterial transit time (ATT) in 28 young adult Fontan patients and 31 age and sex matched control subjects using pseudocontinuous time-encoded arterial spin labeling (PCASL).

Results: CBF and arterial transit time were increased, in Fontan subjects compared with controls. Oxygen delivery was decreased in the anterior and middle cerebral artery distribution.

Impact: These data suggest that physiologic compensation to the low cardiac output state produced by Fontan circulation is insufficient to maintain cerebral oxygen delivery. Time-encoded PCASL potential provides an important biomarker to judge surgical and medical interventions in these patients.

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