Related Experiment Video

Updated: Jun 20, 2026

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Published on: April 24, 2017

18.5K

Myocardial ischemia risk in Fontan candidates with pulmonary atresia with intact ventricular septum

Naoki Masaki1, Hideki Tatewaki2, Satoshi Matsuo2

  • 1Department of Cardiovascular Surgery, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai, 989-3126, Japan. naoki.masaki.b6@tohoku.ac.jp.

General Thoracic and Cardiovascular Surgery
|March 3, 2025
PubMed

Insights

Sinusoidal communication (SC) in Fontan candidates with pulmonary atresia with intact ventricular septum (PA/IVS) is linked to myocardial ischemia risk. Higher SC grades indicate a greater risk, necessitating vigilant patient monitoring.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Sinusoidal communication (SC) is common in Fontan candidates with pulmonary atresia with intact ventricular septum (PA/IVS).
  • Understanding SC dynamics is vital for assessing myocardial perfusion in these patients.

Purpose of the Study:

  • To evaluate the risk of myocardial ischemia in Fontan candidates with PA/IVS.
  • To analyze the relationship between SC severity and myocardial perfusion.

Main Methods:

  • Retrospective analysis of 16 Fontan candidates with PA/IVS undergoing staged palliation (BTS, Glenn, TCPC).
  • Assessment of SC severity and myocardial ischemia risk using angiography and scintigraphy.
  • Correlation analysis between SC grade and scintigraphic ischemic responses.

Main Results:

  • All patients exhibited SCs; significant regression occurred post-Blalock-Taussig shunt (BTS).
  • No significant SC changes were observed after subsequent stages, particularly in coronary arteries without major SCs.
  • A positive correlation was found between higher SC grade and positive ischemic response on scintigraphy.

Conclusions:

  • An SC grade of 2 or higher is associated with a high risk of myocardial ischemia in Fontan candidates with PA/IVS.
  • Careful monitoring and clinical management are essential for these high-risk patients.
Abstract

Keywords:
Myocardial ischemiaPulmonary atresia with intact ventricular septumRight ventricle-dependent coronary circulationSinusoidal communication

More Related Videos

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

3.6K
Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring06:27

Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring

Published on: May 2, 2025

70

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...