Best Cases: Congenital Heart Disease-Real Time 4D-Flow Cardiac MRI Visualization to Assist in Catheter-Based Intervention for Fontan Circuit Obstruction

Real Time 4D-Flow Cardiac MRI Visualization to Assist in Catheter-Based Intervention for Fontan Circuit Obstruction

Video Transcription

Video Summary

The report describes an 11-year-old boy with complex congenital heart disease and a Fontan circulation who developed elevated pulmonary vascular resistance and plastic bronchitis. Before catheterization, advanced imaging—including MRI, 3D modeling, and rapidly processed 4D flow—identified central pulmonary artery hypoplasia and distal Fontan conduit narrowing. Real-time 4D flow visualization helped guide same-day intervention, leading to stenting of both lesions. After treatment, the transpulmonary gradient and PVR improved significantly. The case highlights the clinical value of fast 4D flow processing for identifying obstruction and supporting catheter-based decisions in Fontan patients.

Keywords

Fontan circulation

plastic bronchitis

4D flow MRI

pulmonary artery hypoplasia

catheter-based stenting