Assessment of ventricular function after total cavopulmonary derivation in adult patients: Interest of global longitudinal strain/Reply

Keywords: Univentricular heart, Fontan operation, Echocardiography, Magnetic resonance imaging, Ventricular function, Global longitudinal strain Introduction Total cavopulmonary connection (TCPC) is the final palliative staging procedure for anatomical single ventricles (ASV), in the presence of a unique atrioventricular connection as defined by Anderson and colleagues.1 The method was first introduced by Fontan in 1971.2 Since then, various surgical techniques have been proposed over the years. [...]it is the main cause of morbimortality in this population.3 Cardiac magnetic resonance imaging (CMR) represents the imaging technique of reference in the assessment of volumes and ejection fraction (EF) in the presence of univentricular anatomy. [...]the protocol included multi-slice, multiphase, steady-state cine MR acquisitions in long-axis planes, and short-axis cine acquisitions from the base to the apex of the heart. [...]Late Gadolinium Enhancement (EGE) imaging, native and contrast-enhanced T1 mapping were performed to evaluate the presence and the extent of myocardial fibrosis. [...]angio-CMR and 4D flow sequences were also performed following the protocol to assess the permeability of the TCPC and the pulmonary branches, and to study the corresponding flow dynamics.