A classification of abdominal lymphatic perfusion patterns after Fontan surgery

Area of Science:

• Cardiology
• Medical Imaging
• Pediatric Surgery

Background:

• Fontan surgery complications are often linked to abnormal thoracic lymphatic perfusion.
• Understanding abdominal lymphatic patterns is crucial for managing post-Fontan complications.

Purpose of the Study:

• To classify abnormal abdominal lymphatic perfusion patterns.
• To investigate the impact of these patterns on serum protein levels in patients post-Fontan surgery.

Main Methods:

• Retrospective analysis of 71 patients undergoing Fontan surgery.
• Magnetic resonance imaging with T2-weighted lymphatic imaging and serum protein measurements.
• Classification of abdominal (para-aortic, portal-venous) and thoracic lymphatic patterns.

Main Results:

• Abnormal lymphatic patterns were classified into para-aortic (types 1-4) and portal-venous (types 1-3).
• Higher-grade para-aortic, portal-venous, and thoracic lymphatic abnormalities correlated with lower serum protein levels.
• Significant associations were found between different lymphatic abnormality classifications.

Conclusions:

• Abnormal abdominal lymphatic perfusion patterns can be graded by anatomical severity.
• Increased severity of abdominal and thoracic lymphatic abnormalities is associated with reduced serum protein levels.