Low-dose prospectively gated axial 256-slice CT angiography is a valuable tool in the routine clinical evaluation of infants with CHD, providing a comprehensive three-dimensional evaluation of the cardiac anatomy, including the coronary arteries.

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Morphologic predictors of failed A-PCI on the basis of pre-procedure coronary CTA and CCA imaging may be identified, which may assist in determining which patients with CTO lesions would benefit from an early R-PCI strategy.

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Studying the haemodynamics of the central shunt (CS) and modified Blalock–Taussig shunt (MBTS) benefits the improvement of postoperative recovery for patients with an aorta-pulmonary shunt. Shunt configurations, including CS and MBTS, are virtually reconstructed for infants A and B based on preoperative CT data, and three-dimensional models of A, 11 months after CS, and B, 8 months after MBTS, are reconstructed based on postoperative CT data. A series of parameters including energy loss, wall shear stress, and shunt ratio are computed from simulation to analyse the haemodynamics of CS and MBTS. Our results showed that the shunt ratio of the CS is approximately 30% higher than the MBTS and velocity distribution in the left pulmonary artery (LPA) and right pulmonary artery (RPA) was closer to a natural development in the CS than the MBTS. However, energy loss of the MBTS is lower, and the MBTS can provide more symmetric pulmonary artery (PA) flow than the CS. With the growth of infants A and B, the shunt ratio of infants was decreased, but maximum wall shear stress and the distribution region of high wall shear stress (WSS) were increased, which raises the probability of thrombosis. For infant A, the preoperative abnormal PA structure directly resulted in asymmetric growth of PA after operation, and the LPA/RPA ratio decreased from 0.49 to 0.25. Insufficient reserved length of the MBTS led to traction phenomena with the growth of infant B; on the one hand, it increased the eddy current, and on the other hand, it increased the flow resistance of anastomosis, promoting asymmetric PA flow.

Cardiac magnetic resonance imaging (MRI) is an essential tool for MRI-guided surgery and real-time intervention. The MRI videos are expected to be segmented on-the-fly in real practice. However, existing segmentation methods would suffer from drastic accuracy loss when modified for speedup. In this work, we propose Multiscale Statistical U-Net (MSU-Net) for real-time 3D MRI video segmentation in cardiac surgical guidance. Our idea is to model the input samples as multiscale canonical form distributions for speedup, while the spatio-temporal correlation is still fully utilized. A parallel statistical U-Net is then designed to efficiently process these distributions. The fast data sampling and efficient parallel structure of MSU-Net endorse the fast and accurate inference. Compared with vanilla U-Net and a modified state-of-the-art method GridNet, our method achieves up to 268% and 237% speedup with 1.6% and 3.6% increased Dice scores. arXiv:1909.06726v1 [eess.IV]