Interventional Cardiac MR (iCMR)-based Myocardial Mechanics and Circulatory Flow Dynamics in Patients with Fontan Circulation

Motivation: The complexity of Fontan palliation in single-ventricle physiology prompts the need to understand the associated cardiovascular adaptations and their impact on ventricular function. Goal(s): The research aims to quantify the relationship between single-ventricle contractile function and flow dynamic efficiency within the total cavopulmonary connection. Approach: Utilizing Interventional Cardiac MR and a biomechanical heart model, this study analysed hemodynamic data from 11 post-Fontan procedure patients, correlating myocardial contractility with energy loss (EL) and clinical metrics. Results: The analysis showed that EL significantly predicts myocardial contractility and the max(dP/dt), offering insights into the mechanical implications of Fontan circulation, with potential applications in patient-specific intervention strategies. Impact: This study exemplifies the integration of patient-specific biomechanical modelling with clinical cardiac MRI and hemodynamic data to understand Fontan circulation, potentially providing a quantitative framework for personalized treatment strategies and improving the cardiovascular health of patients with congenital heart disease.