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resonance imaging (MRI) confirmed the severity of the atrioventricular valve regurgitation, and surgical repair was scheduled. On attempt to clarify the morphology of the valve and etiology of the regurgitation prior to surgery, this was difficult to visualize on transthoracic and transesophageal echocardiography (3-D transesophageal echocardiography was unavailable because of the patient’s low weight: 17 kg). MRI was also unable to show the fine structure of the valve. Subsequently, dual-source 128-slice multidetector computed tomography (CT; Siemens SOMATOM Definition Flash) and 4-D imaging were performed. Data were reconstructed in 20 separate phase increments encompassing the entire cardiac cycle, ranging ollowing Fontan procedure, an 8-year-old boy was diagnosed with severe atrioventricular valve regurgitation and poor ventricular function at routine followup on transthoracic echocardiography. He was previously diagnosed with tricuspid atresia with ventriculoarterial discordance (type IIc) and completed a staged Fontan operation with Damus-Kaye-Stansel anastomosis at 3 years of age. His parents stated that he had substantially reduced tolerance to exercise compared with his classmates. On cardiopulmonary exercise test, peak V̇O2 was 21.3 ml/kg/min, which was 50% of the normal level according to the sexand age-matched institutional reference value. Cardiac catheterization and magnetic F

circulation journal

Morphological Assessment of Single-Ventricle Atrioventricular Valve Regurgitation on Dual-Source 128-Slice Multidetector Computed Tomography and 4-Dimensional Imaging