Key result
A single 4D flow cardiac MRI dataset accurately quantified a severely hypoplastic left ventricle (18 mL/m2) and significant pulmonary overcirculation, guiding the decision for single ventricle palliation.
Why the study?
Unbalanced atrioventricular canal anatomy presents a pre-operative assessment challenge regarding whether optimal surgery should be univentricular or biventricular repair.
Does a single 4D flow dataset cardiac MRI accurately assess ventricular volumes and AV valve sizes in a patient with an unbalanced right dominant AV canal?
Case Report (n=1)
No
Does a single 4D flow dataset cardiac MRI accurately assess ventricular volumes and AV valve sizes in a patient with an unbalanced right dominant AV canal?
A single 4D flow dataset cardiac MRI can accurately assess ventricular volumes and AV valve sizes to guide surgical decision-making in patients with unbalanced AV canal.
Caution advised before adopting 4D flow MRI for unbalanced AV canal decisions; leaves open its utility pending validation studies.
Unbalanced atrioventricular (AV) canal anatomy presents a clinical challenge for the pediatric cardiology and cardiothoracic surgical team regarding the pre-operative assessment and ultimately, whether the optimal surgery should consist of a univentricular or biventricular repair. We present such a case of a patient with an unbalanced, right dominant, AV canal where a novel approach to preoperative imaging utilizing a relatively brief cardiac MRI consisting of a single 4D flow dataset was used to accurately assess ventricular volumes and AV valve sizes. This pre-operative imaging assessment was instrumental in the decision-making process for a successful single ventricle palliation for this patient.
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Ream et al. (2026) conducted a case report in Unbalanced right dominant atrioventricular canal and coarctation of the aorta (n=1). Single 4D flow cardiac MRI was evaluated on Left ventricular volume and Qp:Qs ratio. A single 4D flow cardiac MRI dataset accurately quantified a severely hypoplastic left ventricle (18 mL/m2) and significant pulmonary overcirculation, guiding the decision for single ventricle palliation.
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