The pathway of left ventricular blood flow in healthy subjects and patients with corrected atrio-ventricular septum defect: an observational study using 4DFlow MRI and particle tracing

Background Blood entering the left ventricle (LV) through the left atrio-ventricular valve (LAVV) and exiting through the aorta is assumed to follow the most energy efficient pathway. In patients with a corrected atrio-ventricular septal defect (AVSD), this intra-cardiac blood flow pathway may be altered, due to the restricted opening of the LAVV. This might affect optimal LV function. Particle tracing in 4DFlow MRI data enables quantitative evaluation of the temporal distribution of blood particles in the LV. We aimed to compare the LV intra-cardiac blood flow pathway in corrected AVSD patients with that of healthy subjects, using 4DFlow MRI and particle tracing in the standard 16 segment model of the American Heart Association (AHA).