Fontan Revision: Presurgical Planning Using Four-Dimensional (4D) Flow and Three-Dimensional (3D) Printing

World J Pediatr Congenit Heart Surg. 2019 Mar;10(2):245-249. doi: 10.1177/2150135118799641. Epub 2019 Jan 10.


Pulmonary arteriovenous malformations (AVMs) can be a complication of certain postoperative Fontan patients whose hepatic venous blood return is not distributed evenly to both lungs. A ten-year-old female, who had previously undergone staged single ventricle palliation for complex congenital heart disease, underwent a Fontan revision due to significant left-sided pulmonary AVMs and increasing arterial oxygen desaturation. The combination of four-dimensional flow cardiac magnetic resonance imaging and three-dimensional printing enabled presurgical planning for a Fontan takedown and diversion of hepatic venous flow to the azygous vein that resulted in significant clinical improvement.

Keywords: 3D printing; 4D flow; Fontan; magnetic resonance imaging (MRI); pulmonary arteriovenous malformations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arteriovenous Fistula / surgery*
  • Azygos Vein / surgery
  • Child
  • Female
  • Fontan Procedure / methods*
  • Heart Defects, Congenital / surgery
  • Heart Ventricles / abnormalities
  • Heart Ventricles / surgery
  • Humans
  • Magnetic Resonance Imaging / methods
  • Patient Care Planning*
  • Printing, Three-Dimensional*
  • Pulmonary Artery / abnormalities*
  • Pulmonary Artery / surgery
  • Pulmonary Veins / abnormalities*
  • Pulmonary Veins / surgery

Supplementary concepts

  • Pulmonary Arteriovenous Fistulas