@Article{chd.12692,
AUTHOR = {Neil C. Zaki, Michael S. Kelleman, W. James Parks, Timothy C. Slesnick, Michael E. McConnell, Matthew E. Oster},
TITLE = {The utility of cardiac magnetic resonance imaging in postFontan surveillance},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {2},
PAGES = {140--146},
URL = {http://www.techscience.com/schd/v14n2/38760},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Gated cardiac MRI offers the most detailed and accurate noninvasive 
method of assessing cardiac anatomy, particularly in patients with complex congenital 
heart disease. The proposed benefits of using cMRI as a routine screening tool in the 
Fontan population include early recognition of asymptomatic, postoperative anatomic 
and physiologic changes. In 2011, we therefore instituted at our center a recommended 
practice of cMRI screening in patients with Fontan physiology at 3 and 8 years postFontan operation. The purpose of this study was to determine the impact of this standardized practice of cMRI screening on the clinical management of a Fontan 
population.<br/>
<b>Design:</b> We retrospectively reviewed charts from our institutional Fontan database to 
determine which patients were eligible for cMRI under the current guidelines and who 
underwent imaging from November 2002 to June 2015. We reviewed the frequency of 
cMRI and number of changes in management based on the results. Statistical significance was determined using a chi-square test.<br/>
<b>Results:</b> There were 141 cMRIs performed on 121 patients who met inclusion criteria. 
The odds of a change in management were significantly greater after clinically indicated cMRI compared to screening cMRI (OR = 3.79, 95% CI: 1.48-9.66, P = .004). 
There were near significant odds of change in management if the cMRI occurred 
<8 years after Fontan regardless of whether it was for screening or clinically indicated 
purposes (OR = 2.43, 95% CI: 0.97-6.08, P = .052). The most frequent change in management was referral for catheterization with pulmonary artery angioplasty.<br/>
<b>Conclusions:</b> There is an important role for cMRI in routine surveillance of post-Fontan 
patients. Screening cMRI performed less than 8 years after Fontan palliation offers increased utility compared to studies performed later. The optimal timing of such imaging after Fontan palliation remains unclear.},
DOI = {10.1111/chd.12692}
}