Related Experiment Video
Updated: Aug 30, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Serial Doppler assessment of diastolic function before and after the Fontan operation
Margarete Olivier1, Patrick W O'leary, V Shane Pankratz
1Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN 55905, USA.
Insights
The Fontan operation (FO) in patients with univentricular heart showed subtle changes in diastolic function. Ventricular relaxation remained stable post-surgery, offering a benchmark for future assessments.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Univentricular heart presents unique challenges for diastolic function.
- The Fontan operation (FO) is a palliative surgical procedure for complex congenital heart disease.
- Assessing diastolic ventricular function post-FO is crucial for long-term outcomes.
Purpose of the Study:
- To evaluate the impact of the Fontan operation (FO) on diastolic ventricular function.
- To establish a benchmark for diastolic function assessment in palliated univentricular hearts.
Main Methods:
- Serial Doppler echocardiography was performed on 55 patients with univentricular heart.
- Examinations were conducted pre-operation, post-discharge, and 6 months to 6 years after FO.
- Diastolic flow patterns and relaxation times were analyzed.
Main Results:
- Preoperatively, reduced early diastolic atrioventricular valve (E) flow and prolonged deceleration times were observed.
- Post-FO, E/atrial velocity ratios decreased, while diastolic pulmonary vein forward flow increased.
- Deceleration and isovolumic relaxation times remained constant, suggesting stable diastolic function.
Conclusions:
- Univentricular hearts exhibit inherently abnormal ventricular relaxation.
- Post-FO changes in diastolic function are subtle, likely due to reduced preload.
- Diastolic function appears stable after the Fontan operation, providing a valuable reference point.
Abstract:
Serial Doppler echocardiography was used to evaluate the effects of the Fontan operation (FO) on diastolic ventricular function in 55 patients with univentricular heart. Examinations were performed before operation, before postoperative discharge, and 6 months to 6 years postoperatively. Preoperatively, early diastolic atrioventricular valve (E) flow was reduced and deceleration times prolonged relative to healthy children. All pulmonary vein diastolic flow variables, except diastolic velocity, were increased relative to control subjects. After FO, E/atrial velocity and E/atrial time velocity integral ratios were decreased whereas deceleration and isovolumic relaxation time remained constant. Diastolic pulmonary vein forward flow increased after FO. These data suggest inherently abnormal ventricular relaxation in the univentricular heart and that changes in flow patterns observed postoperatively were subtle and likely a result of reduced ventricular preload after FO. Overall, diastolic function most probably remained stable after FO. This information can be used as a benchmark for further diastolic function assessment in patients with surgically palliated univentricular heart.
