Why the study?
Aortic surgeries in congenital conditions aim to restore and maintain aortic conduit and reservoir functions, prompting the development of a 4D flow MRI method to assess these functions.
Does 4D flow MRI identify differences in aortic conduit and reservoir functions between pre-Fontan HLHS patients and age-matched controls?
Observational (n=16)
No
Does 4D flow MRI identify differences in aortic conduit and reservoir functions between pre-Fontan HLHS patients and age-matched controls?
Non-invasive 4D flow MRI reveals that reconstructed neo-aortas in pre-Fontan HLHS patients achieve normalized conduit function at the expense of impaired reservoir function in the ascending aorta, while the descending aorta suffers from impaired conduit function.
Aortic surgeries in congenital conditions, such as hypoplastic left heart syndrome (HLHS), aim to restore and maintain the conduit and reservoir functions of the aorta. We proposed a method to assess these two functions based on 4D flow MRI, and we applied it to study the aorta in pre-Fontan HLHS. Ten pre-Fontan HLHS patients and six age-matched controls were studied to derive the advective pressure difference and viscous dissipation for conduit function, and pulse wave velocity and elastic modulus for reservoir function. The reconstructed neo-aorta in HLHS subjects achieved a good conduit function at a cost of an impaired reservoir function (69.7% increase of elastic modulus). The native descending HLHS aorta displayed enhanced reservoir (elastic modulus being 18.4% smaller) but impaired conduit function (three-fold increase in peak advection). A non-invasive and comprehensive assessment of aortic conduit and reservoir functions is feasible and has potentially clinical relevance in congenital vascular conditions.
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Vecchi et al. (2022) conducted an observational in Hypoplastic left heart syndrome (HLHS) (n=16). Aortic reconstruction (DKS anastomosis and homograft patch) vs. Age-matched controls with non-reconstructed aortas was evaluated on Elastic modulus in the ascending aorta (kPa) (p=0.04).
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