Cardiovascular magnetic resonance in a pregnant patient with absent pulmonary valve syndrome

Oosterhof, Thomas; Vriend, Joris W.J.; Spijkerboer, Anje M.; Mulder, Barbara J.M.

doi:10.1007/s10554-006-9150-3

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…In the axial plane, we found that the carina and the right and left main bronchi in most cases were just inferior and posterior to the dilated right pulmonary artery and usually both the right and left bronchi were compressed to an equal degree by the dilated right pulmonary artery. Bilateral segmental atelectasis and obstructive emphysema were clearly visualized [10, 11]. Our data demonstrated that most cases (65%) had moderate to severe bronchial stenosis.…”

Section: Discussionmentioning

confidence: 66%

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Multi-slice computed tomography assessment of bronchial compression with absent pulmonary valve

Jaffe

Liu

et al. 2014

Pediatr Radiol

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BackgroundAbsent pulmonary valve is a rare cardiovascular anomaly that can result in profound tracheobronchial compression.ObjectiveTo demonstrate the advantage of multi-slice CT in diagnosing tracheobronchial compression, its severity as related to the adjacent dilated pulmonary arteries, and associated lung and cardiac lesions.Materials and methodsWe included children with absent pulmonary valve who were reviewed by multi-slice CT during a 17-year period. The number and locations of stenoses and lung lesions were noted and the severity of stenosis was categorized. The diameter of the pulmonary artery was measured and associated cardiac defects were demonstrated.ResultsThirty-one children (14 girls and 17 boys) were included. Of these, 29 had ventricular septal defect and 2 had an intact ventricular septum. Twenty-nine children (94%) had tracheobronchial compression, judged to be mild in nine children (31%), moderate in 10 (34%) and severe in 10 (34%). The different locations of the stenosis (carina, main bronchi, lobar and segmental bronchi) were observed. And the number and location of lung lesions demonstrated that the right middle and left upper and lower lobes were often affected. The diameter of the pulmonary artery in these children was well above normal published values, and Spearman rank correlation analysis showed a correlation between the size of the pulmonary artery and the severity of the tracheobronchial stenosis. Nineteen children (61%) underwent surgery and 4 of these children had a multi-slice CT post-operative follow-up study.ConclusionAbsent pulmonary valve can cause significant morbidity and mortality in children. Multi-slice CT can accurately depict areas of tracheobronchial compression, associated lung lesions and cardiac defects, helping to direct the surgeon.

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Section: Discussionmentioning

confidence: 66%

“…MRI can demonstrate tracheobronchial compression but it is time-consuming, and prolonged sedation might not be suitable for infants with severe respiratory illness unless performed under general anesthesia [10, 11]. …”

Section: Discussionmentioning

confidence: 99%

Multi-slice computed tomography assessment of bronchial compression with absent pulmonary valve

Jaffe

Liu

et al. 2014

Pediatr Radiol

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“…Published literature reports the use of CMR to delineate specific cardiovascular conditions suspected in pregnancy, including: aortic coarctation, 9 aortic dissection, 10 peri-partum cardiomyopathy, 11,12 and maternal congenital heart disease. 13 Outside of improved visualization, CMR allows for tissue characterization that is not possible using echocardiography. CMR has been used in pregnancy to evaluate and diagnose intra-cardiac masses, 14 acute myocardial infarction, 15 cardiac blood cysts, 16 in addition to evaluation of the myocardium for iron overload (Figure 2).…”

Section: Cmr Applications In Pregnancymentioning

confidence: 99%

Contemporary considerations for the use of cardiovascular magnetic resonance imaging during pregnancy

2019

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Cardiovascular imaging during pregnancy is frequently used to help direct diagnosis and management for women with known or suspected cardiac disease. Although echocardiography is the most commonly used imaging modality in pregnancy, cardiovascular magnetic resonance imaging is an important and increasingly used tool, which can provide complementary, and oftentimes incremental, information regarding cardiovascular anatomy, ventricular function, and vascular flows. Advantages of cardiovascular magnetic resonance imaging over echocardiography and other imaging techniques include superior reproducibility, excellent cross-sectional evaluation of cardiac structures, high spatial resolution, and lack of ionizing radiation (a limitation of computed tomography and conventional catheter-based angiography). Cardiovascular magnetic resonance imaging in the absence of gadolinium-based contrast agents poses no known risk to the mother or fetus and its applications in pregnancy are expanding. Clinicians should be familiar with the role of cardiovascular magnetic resonance imaging in pregnancy to optimize and enhance care for mothers with heart disease.

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“…However, the effect of a gadolinium‐based contrast agent on the fetus is not well‐characterized, and thus should be used only after completion of the first trimester 11 . Magnetic resonance imaging can be used in pregnancy to assess right ventricular dysfunction or pulmonary insufficiency if quantification of these lesions would assist management 12 …”

Section: Cardiac Evaluationmentioning

confidence: 99%

“…11 Magnetic resonance imaging can be used in pre-gnancy to assess right ventricular dysfunction or pulmonary insufficiency if quantification of these lesions would assist management. 12…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Practical Assessment of Maternal Cardiovascular Risk in Pregnancy

Moghbeli¹,

Paré

Webb

2008

Congenital Heart Disease

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Cardiovascular disease in pregnancy is the most common cause of maternal mortality in the developed world and an important cause of heart failure, stroke, and arrhythmia. As more children with congenital heart disease survive into adulthood, there is a more pressing need to understand the risks that pregnancy poses for these women. Pregnancy, labor, and delivery increase the hemodynamic stress on the cardiovascular system and place women with heart disease at increased risk of cardiovascular complications, which include heart failure and death. Systematic assessment of pregnancy risk in these women, ideally before conception, is essential in optimizing maternal and fetal outcomes. This article describes the process of assessing risk of pregnancy-associated cardiovascular complications in women with structural heart disease. We review the current literature on pregnancy risk in women with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy, and suggest an approach to risk stratification. Based on a review of the literature, we report features that pose an increased risk of adverse maternal and fetal outcomes, which include poor maternal functional status; prior history of heart failure, arrhythmia, or cerebral vascular events; cyanosis; poor systemic ventricular function; and severe aortic or mitral stenosis. Pulmonary hypertension and Eisenmenger syndrome place women at exceedingly high risk for cardiovascular complications in pregnancy, including maternal and fetal death.

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Cardiovascular magnetic resonance in a pregnant patient with absent pulmonary valve syndrome

Cited by 5 publications

References 8 publications

Multi-slice computed tomography assessment of bronchial compression with absent pulmonary valve

Multi-slice computed tomography assessment of bronchial compression with absent pulmonary valve

Contemporary considerations for the use of cardiovascular magnetic resonance imaging during pregnancy

Practical Assessment of Maternal Cardiovascular Risk in Pregnancy

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