Predictive Models for Pulmonary Artery Size in Fontan Patients

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• The Fontan procedure is a palliative surgery for complex congenital heart disease.
• Pulmonary artery (PA) size is a critical indicator of cardiovascular health in Fontan patients.
• Accurate PA size assessment is essential for monitoring and managing Fontan-associated complications.

Purpose of the Study:

• To develop predictive models for pulmonary artery (PA) size in Fontan patients based on age and body surface area (BSA).
• To compare PA size models between Fontan patients with extracardiac conduits (ECC) and non-ECC groups.
• To establish reference standards for PA dimensions in Fontan physiology.

Main Methods:

• Linear regression and breakpoint analyses were applied to data from 43 Fontan patients (24 ECC, 19 non-ECC).
• Developed models were validated against a control group (n=18) and existing literature.
• Correlations between mean PA diameter, BSA, and age were assessed.

Main Results:

• Strong positive correlations were found between mean PA diameter and both BSA (r=0.9) and age (r=0.88) in the ECC group (p<0.05).
• Model predictions showed less than 16% and 20% difference compared to published literature for BSA and age, respectively.
• Fontan patients' predicted PA size was consistently smaller than that of the control group.

Conclusions:

• Developed models provide reliable estimations of PA size in Fontan patients as a function of age and BSA.
• These models can serve as clinical references and aid in creating patient-specific 3D anatomical models.
• Findings highlight the reduced PA dimensions in Fontan physiology compared to healthy controls.