Key result
Post-Fontan patients show lower pulmonary artery flow, distensibility, and wall shear stress versus healthy controls.
Why the study?
Pulmonary artery size, flow variables, and wall shear stress after Fontan operation at a young age have not been fully characterized, particularly under stress conditions.
How do pulmonary artery size, flow variables, and wall shear stress in patients after Fontan operation compare to healthy controls at rest and during dobutamine stress?
Observational (n=31)
How do pulmonary artery size, flow variables, and wall shear stress in patients after Fontan operation compare to healthy controls at rest and during dobutamine stress?
Patients after Fontan operation have normal pulmonary artery size but significantly impaired flow variables, distensibility, and wall shear stress compared to healthy controls, indicating potential vascular dysfunction.
Answers are grounded in this paper and cite their sources.
May indicate pulmonary vascular dysfunction post-Fontan; leaves open whether metrics predict outcomes or guide interventions.
PURPOSE: To assess pulmonary artery (PA) size, flow variables, and wall shear stress (WSS) in patients after Fontan operation at a young age. MATERIALS AND METHODS: Flow in the branch PA was obtained with phase contrast velocity-encoded cardiovascular magnetic resonance imaging in 14 patients before and after low-dose dobutamine stress (7.5 microg/kg/min) and in 17 healthy controls at rest. RESULTS: At rest, stroke index, total flow, average, and peak flow rate were all statistically significantly lower in patients than in controls (P<0.001). With stress-testing, all variables increased in patients (P<0.001), apart from stroke index, which did not change. At rest, branch PA area did not differ between patients and controls. Distensibility was lower in patients than in controls (P<0.001). With stress-testing, area and distensibility did not change. At rest, WSS was lower in patients than in controls (P<0.001). WSS increased with stress-testing (P<0.001), but not to the same levels as during resting conditions of the control group. CONCLUSION: PA size is normal long-term after Fontan operation at a young age. Flow variables, distensibility, and WSS are significantly lower compared to healthy controls, and do not show adequate reactions with stress-testing, which is suggestive of pulmonary artery endothelial and/or vascular dysfunction.
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Robbers‐Visser et al. (2008) conducted an observational in Fontan operation at a young age (n=31). Fontan operation at a young age vs. Healthy controls was evaluated on Pulmonary artery size, flow variables, and wall shear stress (p=<0.001). Patients after Fontan operation had significantly lower pulmonary artery flow variables, distensibility, and wall shear stress compared to healthy controls at rest (P<0.001).
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