Evaluation of an unbalanced right dominant atrioventricular canal with a single 4D flow dataset

Unbalanced atrioventricular (AV) canal anatomy presents a clinical challenge for the pediatric cardiology and cardiothoracic surgical team regarding the pre-operative assessment and ultimately, whether the optimal surgery should consist of a univentricular or biventricular repair. We present such a case of a patient with an unbalanced, right dominant, AV canal where a novel approach to preoperative imaging utilizing a relatively brief cardiac MRI consisting of a single 4D flow dataset was used to accurately assess ventricular volumes and AV valve sizes. This pre-operative imaging assessment was instrumental in the decision-making process for a successful single ventricle palliation for this patient.