Assessment of vascular remodeling after the Fontan procedure using a novel very high resolution ultrasound method: arterial wall thinning and venous thickening in late follow-up.

Heart and Vessels
Taisto SarkolaAndrew N Redington

Abstract

The Fontan circulation is associated with an increased central venous pressure, decreased ventricular preload, and increased afterload. We postulated that these central hemodynamic abnormalities would have consequences for the structural and functional properties of the peripheral arteries and veins, and performed a cross-sectional study in a tertiary health-care setting. We prospectively examined venous and arterial wall morphology by very high resolution ultrasound (VHRU, 25-55 MHz), and function by conventional vascular ultrasound (flow-mediated dilatation, FMD) and applanation tonometry (pulse wave velocity, PWV) in 28 patients after the Fontan procedure (age 14.8 ± 1.3 years) and 54 age-matched controls. Pig venous samples were studied with VHRU and compared with histology for accuracy. The precision of the venous VHRU method was studied in healthy volunteers. The lumen dimension was reduced in Fontans compared with controls in the common carotid, brachial, radial, and femoral arteries (p < 0.05). The common carotid, brachial, radial, ulnar, femoral, and dorsal tibial artery intima-media thicknesses (IMTs) and the brachial, ulnar, and femoral artery adventitial thicknesses were decreased (p < 0.05 for all), while the cubit...Continue Reading

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Citations

Aug 6, 2013·Current Treatment Options in Cardiovascular Medicine·Ari CedarsPhilip Ludbrook
Sep 21, 2015·Heart and Vessels·Mikiko ShimizuToshio Nakanishi
Aug 16, 2015·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Elaine M Urbina
Jan 10, 2018·Cardiology in the Young·Chaitanya PanchangamGeetha Raghuveer
Aug 11, 2017·Congenital Heart Disease·Gruschen R VeldtmanMarc Gewillig
Oct 22, 2014·Circulation·Jack Rychik, David J Goldberg
Sep 25, 2016·Journal of the American Heart Association·Bryan H GoldsteinBradley S Marino
Nov 19, 2019·Circulation·David J GoldbergUNKNOWN Pediatric Heart Network Investigators
Jul 30, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Rossana IzzettiMario Gabriele
Aug 24, 2021·Heart, Lung & Circulation·Kieran SandhuJonathan P Mynard

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