Combined CMR and Catheterization for Pre-Fontan Evaluation: Comparing Metrics and Clinical Correlations
Key result
CMR yields ~0.41 higher Qp/Qs than catheterization, linked to aortopulmonary collateral burden.
- p<0.0001
Why the study?
Cardiac magnetic resonance imaging is increasingly combined with cardiac catheterization for pre-Fontan evaluation of children with single ventricle physiology, motivating an assessment of institutional experience with this combined approach.
Does CMR provide superior quantification of Qp/Qs and aortopulmonary collateral burden compared to cardiac catheterization in children undergoing pre-Fontan evaluation?
Population
57 single-ventricle patients undergoing pre-Fontan evaluation
Comparison
CMR- vs Cath-based Qp/Qs and aortopulmonary collateral assessments
Design
Retrospective single-center study
Authors
Discussion
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Member takes
Implication
Supports integrating CMR into pre-Fontan evaluation; extends evidence for its superiority in aortopulmonary collateral burden quantification.
Key Points
- This study aims to evaluate the effectiveness of combined CMR and catheterization for the pre-Fontan evaluation.
- Conducted a retrospective analysis in a single-center study
- Included 57 single-ventricle patients undergoing CMR and catheterization
- Compared Qp/Qs values between CMR and catheterization
- Assessed the relationship between APC burden, hemodynamics, and postoperative outcomes
- CMR provided higher Qp/Qs values than catheterization, with a mean underestimation of 0.41 from Cath
- Strong correlation found between CMR-derived APC burden and Qp/Qs (p<0.0001)
- CMR APC burden correlated with increased indexed ventricular volumes and lower ejection fractions
- Cath-based qualitative APC assessments poorly correlated with CMR findings
Structured PICO
Does CMR provide superior quantification of Qp/Qs and aortopulmonary collateral burden compared to cardiac catheterization in children undergoing pre-Fontan evaluation?
P
Population
57 children with single ventricle (SV) physiology undergoing pre-Fontan evaluation
I
Intervention
Cardiac magnetic resonance imaging (CMR) assessment
C
Comparator
Cardiac catheterization (Cath) assessment
O
Outcome
Comparison of pulmonary and systemic blood flow ratio (Qp/Qs) and aortopulmonary collateral (APC) assessmentssurrogate
Combined CMR and catheterization provides comprehensive pre-Fontan assessment, with CMR offering superior quantification of aortopulmonary collateral burden compared to catheterization alone.
Limitations
- retrospective design
- single-center
Cite This Study
Shrivastava et al. (2026) studied this question. CMR yielded higher Qp/Qs values than catheterization, which underestimated Qp/Qs by a mean of 0.41, a difference strongly correlated with aortopulmonary collateral burden (p<0.0001).