AI Article Synopsis
- A study examined the relationship between Doppler ultrasound-derived mean fenestration gradient (mFG) and direct measurements of transpulmonary gradient (TPG) in patients who underwent the Fontan procedure, a common surgical treatment for single ventricle anatomy.
- The research included 59 patients from a single center between 2000 and 2022 and found that mFG and TPG were weakly correlated, indicating that mFG can only explain about 38% of the variance in TPG measurements.
- The study suggests that while mFG offers a non-invasive way to assess TPG, healthcare providers should be cautious and consider direct catheterization for accurate evaluations in Fontan patients.
Article Abstract
Background: Patients born with single ventricle anatomy typically undergo surgical palliation in three stages, culminating in the Fontan procedure. Assessment of flow across a Fontan fenestration by Doppler ultrasound theoretically allows for non-invasive estimation of the transpulmonary gradient (TPG). Our objective was to determine the relationship between Doppler-derived mean fenestration gradient (mFG) and direct catheter-based measurements of TPG in patients with fenestrated Fontans.
Methods: We performed a single-center retrospective cohort study of 59 patients with fenestrated Fontans completed between 2000 and 2022. The primary outcome was catheter-based measurement of TPG and the primary predictor was mFG from echo performed within 6 months of the catheterization. Linear regression and R were used to determine the relationship between predictors and outcomes.
Results: Catheter-based measurements of TPG and mFG were weakly correlated (R = 0.382, p < 0.001); the regression coefficient was 0.550, with a standard error of 0.09 for every increase in mFG (Cath TPG = 0.55 [mFG] + 1.92). mFG had a slightly better predictive relationship with cath-derived TPG in patients with systemic left ventricles with R of 0.47, p < 0.004.
Conclusion: mFG accounts for approximately 38% of the variance in catheter-derived TPG. Although mFG is non-invasive and intuitive, mFG in Fontan patients should be interpreted with caution and direct measurement by cardiac catheterization should be considered.
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| http://dx.doi.org/10.1007/s00246-024-03651-1 | DOI Listing |
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