Imaging of complications following Fontan circulation in children - diagnosis and surveillance

Area of Science:

• Pediatric Cardiology
• Medical Imaging
• Congenital Heart Disease

Background:

• The Fontan operation is a palliative procedure for single-ventricle physiology.
• Increasing survival rates necessitate better understanding of long-term complications.
• Healthcare providers require enhanced knowledge of Fontan circulation and its sequelae.

Purpose of the Study:

• To review the anatomical and functional aspects of Fontan palliation.
• To provide an overview of long-term organ complications in pediatric Fontan patients.
• To emphasize the role of radiology in diagnosing and managing these complications.

Main Methods:

• Literature review of Fontan circulation and associated organ complications.
• Focus on the diagnostic and monitoring capabilities of various imaging modalities (US, MRI, CT).
• Discussion of quantitative imaging techniques adapted for pediatric Fontan surveillance.

Main Results:

• Fontan palliation presents numerous long-term organ complications, including cardiac, hepatic, renal, and neuropsychological issues.
• Radiology is pivotal for diagnosis, therapy monitoring, and outcome prediction in pediatric Fontan patients.
• New quantitative imaging techniques offer improved surveillance strategies.

Conclusions:

• Fontan-associated liver disease and other organ dysfunctions are significant concerns.
• Radiological surveillance is essential for optimizing care and outcomes in pediatric Fontan survivors.
• Advanced imaging techniques are vital for developing effective monitoring strategies.