Fontan Patients Exhibit Altered CBF and ATT Measurements in Gray and White Matter: an ASL Study.

Motivation: Patients with Fontan palliation of single ventricular heart disease have significant cognitive deficits that may result from their chronically low cardiac output. Goal(s): To determine whether global and regional brain oxygen delivery is normal in young adults after Fontan palliation. Approach: We measured cerebral blood flow (CBF) and arterial transit time (ATT) in 28 young adult Fontan patients and 31 age and sex matched control subjects using pseudocontinuous time-encoded arterial spin labeling (PCASL). Results: CBF and arterial transit time were increased, in Fontan subjects compared with controls. Oxygen delivery was decreased in the anterior and middle cerebral artery distribution. Impact: These data suggest that physiologic compensation to the low cardiac output state produced by Fontan circulation is insufficient to maintain cerebral oxygen delivery. Time-encoded PCASL potential provides an important biomarker to judge surgical and medical interventions in these patients.