Congenital heart disease affects approximately 1.2% of children and is the leading cause of birth defect-related deaths. Single ventricle heart disease is a severe form of congenital heart disease, with high morbidity and mortality. These patients require multiple palliative surgeries, culminating with a total cavopulmonary anastomosis (Fontan operation). Despite considerable improvements in the survival of patients with single ventricle heart disease, there is an increasing morbidity and mortality over time. It remains unclear why some single ventricle heart disease patients fail their surgical repairs while others remain relatively well. Clinicians often rely on 2-dimensional images acquired from echocardiograms, catheterizations, or cardiovascular magnetic resonance imaging exams to assess single ventricle heart disease patients. The 2-dimensional images often lead to a suboptimal understanding of the complex 3-dimensional spatial relationships and hemodynamics, and limit efficient decision making. Moreover, catheterization is invasive and associated with x-ray radiation exposure. Lengthy cardiovascular magnetic resonance imaging exams in young children require anesthesia which is associated with neurological development impairments.

To address these deficiencies, we will develop a 3-dimensional cine cardiovascular magnetic resonance imaging technique that reduces examination time to <20 minutes compared with the 60-90 minute conventional exams, and, consequently, reduces the risk associated with general anesthesia. It will also enable the noninvasive measurement of other imaging biomarkers, such as pressure differences in the heart and great vessels, which will improve the risk assessment of patients at high risk of heart failure after the Fontan procedure.