Noninvasive Assessment of Central Venous Pressure Following TCPC Operation for Univentricular Palliation

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All articles of this category (opens in new window) Background: Central venous pressure (CVP) reflects the degree of venous congestion after the Fontan operation for univentricular palliation. However, CVP measurement is an invasive procedure and is not routinely performed in the outpatient care of young patients with Fontan circulation. The aim of this study was to evaluate a noninvasive technique for estimating CVP in a cohort of young patients after TCPC operation. Methods: The collapse point of the internal jugular vein was identified by ultrasound in an upright position and marked on the skin. The pulmonary artery level was determined between Th5 and Th6 by rib counting via ultrasound and marked in the same manner. The vertical distance between the two skin marks was measured with a linear laser system and converted into an estimated noninvasive central venous pressure (eCVP) using the formula: eCVP (mmHg) = distance (cm) × 0.74. These estimates were compared with simultaneously obtained invasive iCVP measurements. Results: A total of 13 subjects (7/13 female) were enrolled at a median of 5 days (IQR: 4–10) after TCPC operation. The median age was 4.5 years (IQR: 3.6–9), and the median body weight was 14.8 kg (IQR: 13–26.8). The systemic ventricle had a left ventricular morphology in 7/13 and a right ventricular morphology in 6/13 subjects. The median transcutaneous oxygen saturation was 96% (IQR: 94–97). Estimated eCVP values were lower than invasively measured iCVP values (median: 8 mm Hg, IQR: 5–9, vs. 9 mm Hg, IQR: 6–11). In 1/13 subjects, eCVP underestimated iCVP by 5 mm Hg, whereas in all other cases, differences were within ± 3 mm Hg. Conclusion: Noninvasive assessment of CVP was technically feasible and may represent a valuable option for outpatient follow-up after Fontan surgery. Regardless of the absolute value, eCVP could serve as an individual follow-up marker. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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