A preoperative estimate of central venous pressure is associated with early Fontan failure

In this study, cardiac magnetic resonance (CMR) imaging was performed in patients with bidirectional cavopulmonary connection (BCPC) undergoing preoperative assessment for total cavopulmonary connection (TCPC). We used routinely collected data: pulmonary blood flow (Qp), central venous pressure (CVP), and aortic flow. We calculated a metric that attempts to estimate how much CVP would increase should the TCPC be completed if all systemic flow is directed to the lungs. Given that early Fontan failure (EFF) is associated with high postoperative CVP, we investigated whether this metric was associated with EFF events and if it correlated to directly measured CVP in the TCPC during the intensive care unit (ICU) stay. Our study demonstrates an association between estimated TCPC pressure and EFF, and a moderate correlation with CVP measured in the ICU.