Pediatric and Congenital Heart Disease Session 2: Frontiers in Single Ventricle Heart Disease (2020)-Is Pre-operative Catheterization Necessary in Patients with Single Ventricle Heart Disease?

Is Pre-operative Catheterization Necessary in Patients with Single Ventricle Heart Disease?

Video Transcription

Video Summary

The speaker argues that routine cardiac catheterization is not needed before single-ventricle palliative surgery, except in selected higher-risk cases. Pre-op evaluation should assess anatomy, ventricular and valve function, venous anatomy, arch obstruction, collaterals, and pulmonary vascular resistance. Studies show that in low-risk Glenn and Fontan patients, MRI/echo can be an acceptable alternative to cath, with similar outcomes and fewer risks. Cath carries complication and radiation risks. A stepwise approach is recommended: echo first, then MRI, then cath only if high-risk findings are present, such as arch obstruction, treatable PA stenosis, significant collaterals, pulmonary vein stenosis, or major dysfunction.

Keywords

single-ventricle surgery

cardiac catheterization

preoperative evaluation

MRI and echocardiography

pulmonary vascular resistance