Usefulness of 4D-Flow MRI in Mapping Flow Distribution Through Failing Fontan Circulation Prior to Cardiac Intervention

  • Daniel McLennanEmail author
  • Michal Schäfer
  • Max B. Mitchell
  • Gareth J. Morgan
  • Dunbar Ivy
  • Alex J. Barker
  • Roni Jacobsen
Case Report


We report a case of a 23-year-old male with failing Fontan circulation who was taken to the catheterization lab to better evaluate the Fontan circulation and hemodynamics. Catheterization revealed arteriovenous malformations exclusively present in the right lung leading to the consideration of placing stents to direct the inferior vena cava flow through the Fontan circuit to the right pulmonary artery (RPA), thus increasing the RPA concentration of the hepatic factor. However, comprehensive 4D-Flow MRI analyses indicated sufficient distribution of the hepatic flow between branch pulmonary arteries, and consequently no further invasive intervention to redirect hepatic flow was performed.


Fontan circulation Flow MRI 



There was no funding provided for this article.

Compliance with Ethical Standards

Conflict of interest

No author involved in this case review has any conflicts of interest pertinent to the study.

Ethical Approval

This article is a retrospective case study and is in compliance with ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Cardiology, Heart Institute, Children’s Hospital ColoradoUniversity of Colorado Denver, Anschutz Medical CampusAuroraUSA
  2. 2.Section of Congenital Heart Surgery, Heart Institute, Children’s Hospital ColoradoUniversity of Colorado Denver, Anschutz Medical CampusAuroraUSA

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