Cardiovasc Imaging Asia.  2017 Apr;1(2):133-145. 10.22468/cvia.2016.00157.

CT and MRI Evaluation of the Fontan Pathway: Pearls and Pitfalls

• Hong SH
• Kim YM
• Lee CH
• Park SJ
• Kim SH

• KMID: 2524840
• DOI: http://doi.org/10.22468/cvia.2016.00157

Abstract

The Fontan pathway is the result of a palliative surgical procedure achieved by direct anastomosis of systemic veins to the pulmonary arteries, bypassing a ventricle. It is performed in patients with functional univentricular heart physiology in which biventricular repair is not possible. Advances in surgical techniques with modified Fontan procedures have led to improved long-term results and increased life expectancy in such patients. Consequently, late complications of the Fontan procedure are being increasingly encountered, particularly in patients with poor hemodynamics. Accordingly, radiologists are increasingly likely to encounter longterm complications of the Fontan pathway in certain cardiac patients. The purpose of this article is to familiarize radiologists with the surgical techniques of the Fontan procedure, to describe the technical considerations for optimal image acquisition and the expected normal postoperative anatomy, and to illustrate the imaging findings of postoperative complications in these patients.

Keyword

Heart defects; congenital; Fontan procedure; Multidetector computed tomography; Magnetic resonance imaging