Related Experiment Video
Updated: Jun 12, 2026
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Evaluation of an unbalanced right dominant atrioventricular canal with a single 4D flow dataset
Stephen Ream1, Laura Schoeneberg2, Wilson King3
1SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, MO, USA. Stephen.c.ream@health.slu.edu.
Insights
Unbalanced atrioventricular canal anatomy poses surgical challenges. A brief cardiac MRI with 4D flow imaging accurately assessed ventricular volumes, guiding successful single ventricle palliation.
Area of Science:
- Pediatric Cardiology
- Cardiothoracic Surgery
- Medical Imaging
Background:
- Unbalanced atrioventricular (AV) canal anatomy presents complex pre-operative assessment challenges.
- Determining between univentricular or biventricular repair is critical for pediatric patients.
- Accurate ventricular and AV valve sizing is essential for surgical planning.
Purpose of the Study:
- To present a case of unbalanced, right dominant AV canal.
- To highlight a novel preoperative imaging approach using cardiac MRI with 4D flow.
- To demonstrate the utility of this imaging in surgical decision-making.
Main Methods:
- A brief cardiac MRI scan was performed.
- A single 4D flow dataset was utilized for analysis.
- Ventricular volumes and AV valve sizes were accurately assessed.
Main Results:
- The 4D flow MRI provided accurate measurements of ventricular volumes and AV valve sizes.
- This imaging approach was instrumental in the surgical decision-making process.
- The patient underwent successful single ventricle palliation.
Conclusions:
- Cardiac MRI with 4D flow is a valuable tool for assessing unbalanced AV canal anatomy.
- This non-invasive imaging technique aids in planning complex pediatric cardiac surgeries.
- Accurate pre-operative assessment leads to successful surgical outcomes in challenging cases.
Abstract:
Unbalanced atrioventricular (AV) canal anatomy presents a clinical challenge for the pediatric cardiology and cardiothoracic surgical team regarding the pre-operative assessment and ultimately, whether the optimal surgery should consist of a univentricular or biventricular repair. We present such a case of a patient with an unbalanced, right dominant, AV canal where a novel approach to preoperative imaging utilizing a relatively brief cardiac MRI consisting of a single 4D flow dataset was used to accurately assess ventricular volumes and AV valve sizes. This pre-operative imaging assessment was instrumental in the decision-making process for a successful single ventricle palliation for this patient.
