Single Ventricle: Radiology Primer for Preprocedural Evaluation

Area of Science:

• Cardiology
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Single ventricle is a complex congenital heart abnormality where one ventricle is insufficient for dual circulation.
• It encompasses diverse anatomical and functional variations, posing significant management challenges.

Purpose of the Study:

• To highlight the critical role of imaging in classifying single ventricle defects.
• To detail imaging modalities and parameters essential for surgical planning and patient management.

Main Methods:

• Echocardiography as the primary imaging modality.
• MRI and CT for complex vascular anatomy assessment when echocardiography is limited.
• Review of critical imaging parameters for presurgical evaluation.

Main Results:

• Single ventricle anatomy can involve one or two atria connected to a single ventricle, or hypoplastic ventricles.
• Functional single ventricle arises from conditions like severe valve dysfunction or obstructive lesions.
• Key imaging parameters include ventricular/valvular function, vascular anatomy, and hemodynamic factors.

Conclusions:

• Accurate imaging is vital for classifying single ventricle defects and guiding treatment strategies.
• Management often involves staged palliation, with biventricular repair or heart transplant as alternatives.
• Comprehensive presurgical imaging assessment is essential for optimal outcomes.