"CMR for Functionally Single Ventricle" - Case-Based Webinar (CME)-Video

Video Transcription

Video Summary

This webinar covered cardiac MRI applications in congenital heart disease, focusing on cyanotic Fontan patients and borderline left ventricles. Dr. Lam reviewed Fontan types, explaining why extracardiac and lateral tunnel Fontans are most common, and highlighted CMR’s strengths: reproducible serial assessment, outcome prediction, and detailed evaluation of complications such as ventricular dysfunction, fibrosis, collateral flow, thrombi, pulmonary AVMs, lymphatic disease, and Fontan-associated liver disease. Through three cases, he showed how CMR can quantify veno-venous collaterals and pulmonary AVMs and guide decisions about collateral closure and surgical planning.  <br /><br />Dr. Yu then discussed decision-making in borderline left ventricle hypoplasia, emphasizing that no single ventricular volume cutoff applies to all lesions. He showed how CMR can measure ventricular volumes, function, mass, valve anatomy, and flow patterns to determine whether a heart is better suited for biventricular repair or single-ventricle palliation. He stressed that myocardial health, septal position, and the potential for left ventricular growth matter as much as volume. Overall, the session emphasized careful preoperative imaging, individualized assessment, and multimodality collaboration to guide complex congenital heart disease management.

Keywords

cardiac MRI

congenital heart disease

Fontan circulation

cyanotic Fontan patients

borderline left ventricle

veno-venous collaterals

pulmonary arteriovenous malformations

biventricular repair

single-ventricle palliation