Visualization of flow structures in Fontan patients using 3-dimensional phase contrast magnetic resonance imaging Kartik S. Sundareswaran, PhD, Christopher.

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Visualization of flow structures in Fontan patients using 3-dimensional phase contrast magnetic resonance imaging Kartik S. Sundareswaran, PhD, Christopher M. Haggerty, BS, Diane de Zélicourt, PhD, Lakshmi P. Dasi, PhD, Kerem Pekkan, PhD, David H. Frakes, PhD, Andrew J. Powell, MD, Kirk R. Kanter, MD, Mark A. Fogel, MD, Ajit P. Yoganathan, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 143, Issue 5, Pages 1108-1116 (May 2012) DOI: 10.1016/j.jtcvs.2011.09.067 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Coronal acquisition of PC MRI slices throughout the entire TCPC volume. PC MRI, Phase-contrast magnetic resonance imaging; TCPC, total cavopulmonary connection; S, superior; I, inferior; A, anterior; P, posterior; R, right; L, left. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1108-1116DOI: (10.1016/j.jtcvs.2011.09.067) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Benefit of performing 3-dimensional (3D) flow analyses: A, Magnitude image of a PC MRI acquisition with flow streamlines drawn using 2D velocity fields from part B. B, Vector field obtained from the 2D PC MRI. C, A fully interpolated 3D data set with flow streamlines evaluated from the interpolated 3D velocity field. D, 2D vector field obtained from the interpolate data set at the same location as part B. PC MRI, Phase-contrast magnetic resonance imaging. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1108-1116DOI: (10.1016/j.jtcvs.2011.09.067) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Time-varying flow structures color coded by velocity magnitude of an EC (left panel) and LT TCPC (right panel). TCPC, Total cavopulmonary connection; EC, extracardiac; LT, lateral tunnel; SVC, superior vena cava; IVC, inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1108-1116DOI: (10.1016/j.jtcvs.2011.09.067) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Three-dimensional (3D) flow structures through 4 EC TCPC models with varying geometries. Left pane, Flow streamlines color-coded by velocity magnitude. Middle pane, Flow streamlines color-coded by their source of origin (SVC, red; IVC, blue). Right pane, Waveforms depicting varying IVC-LPA flow splits over the cardiac cycle. TCPC, Total cavopulmonary connection; EC, extracardiac; SVC, superior vena cava; IVC, inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery; V, velocity. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1108-1116DOI: (10.1016/j.jtcvs.2011.09.067) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Color-coded 3-dimensional (3D) flow streamlines of the remaining 4 EC (left panel) and LT TCPCs (right panel). TCPC, Total cavopulmonary connection; EC, extracardiac; LT, lateral tunnel; SVC, superior vena cava; IVC, inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery; V, velocity. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1108-1116DOI: (10.1016/j.jtcvs.2011.09.067) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Three-dimensional (3D) flow structures through 4 LT TCPC models with varying geometries. Left pane, Flow streamlines color-coded by velocity magnitude. Middle pane, Flow streamlines color-coded by their source of origin (SVC, red; IVC, blue). Right pane, Wave forms depicting varying IVC-LPA flow splits over the cardiac cycle. TCPC, Total cavopulmonary connection; LT, lateral tunnel; SVC, superior vena cava; IVC, inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery; V, velocity. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1108-1116DOI: (10.1016/j.jtcvs.2011.09.067) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions