CT and MRI for Repaired Complex Adult Congenital Heart Diseases

Siripornpitak, Suvipaporn; Goo, Hyun Woo

doi:10.3348/kjr.2020.0895

Cited by 11 publications

(4 citation statements)

References 78 publications

(116 reference statements)

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“…With its high spatial resolution and ability for three-dimensional reconstruction, cardiac computed tomography offers delineation of complex congenital cardiac anomalies and calcified structures such as homograft and prosthetic valves, while metallic artifacts from sternal wires and stents can often degrade cardiovascular magnetic resonance images. 8 However, the cumulative risk from radiation exposure in cardiac computed tomography needs to be taken into consideration, especially as patients with congenital heart disease often seek care at early ages. 9 …”

Section: Discussionmentioning

confidence: 99%

Pulmonary Artery Stump Thrombus in a Patient With Remote History of Rastelli Procedure

Li,

Guan,

Nguyen

et al. 2024

CASE

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Section: Discussionmentioning

confidence: 99%

Pulmonary Artery Stump Thrombus in a Patient With Remote History of Rastelli Procedure

Li,

Guan,

Nguyen

et al. 2024

CASE

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“…Computed tomography can also be useful in monitoring the morphology of the PAs after stent procedures. 14 However, neither of these advanced imaging methods were measured frequently in this study, preventing proper evaluation and analysis of these tools in our cohort. The determination to refer for advanced imaging is physician-specific and may have been restricted or biased based on primary physician preference for these patients.…”

Section: Commentmentioning

confidence: 91%

Prevalence of Branch Pulmonary Artery Reintervention Following the Arterial Switch Operation

Miller,

Kozik,

Kurtz

2023

World J Pediatr Congenit Heart Surg

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Background The arterial switch operation (ASO) is the preferred surgical procedure used to correct dextro-transposition of the great arteries. A known complication of the ASO is branch pulmonary arteries (PAs) stenosis, which may require reintervention. Our goal is to determine the frequency of reintervention after the ASO and any factors associated with reintervention. Methods This was a single center, retrospective study of infants who underwent the ASO from June 6, 2011 to February 21, 2021. The primary outcome was the prevalence of reintervention on the PAs following the ASO. Results Sixty-eight infants were analyzed; 9 (13%) patients had 10 reinterventions. The mean age at time of the ASO was 6.52 ± 6.63 days; weight was 3.34 ± 0.57 kg. Those with a reintervention had a longer bypass time ( P = .047). Mean age at reintervention was 0.80 ± 0.72 years; mean time from the ASO to reintervention was 0.799 ± 0.717 years. Six surgical procedures, two stent placements, and four balloon angioplasties were performed on a total of 13 branch PAs. There was no increased risk for reintervention on the right versus left PA. After reintervention, there was an improvement in the minimal PA diameter and echo gradient. There were no adverse events or mortality related to the reintervention. Mean follow-up was 6.17 ± 2.94 years. Conclusion The prevalence of branch PA reintervention following the ASO in our cohort was 13%. There is an association between longer cardiopulmonary bypass time and reintervention. After reintervention, there was an increase in PA diameter and a decrease in echo gradient.

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“…Consequently, CMR and echocardiography have been studied extensively to aid in the evaluation of these patients. Due to the unique anatomy of the RV, CMR is the preferred imaging modality for evaluating the right heart (22,23) and numerous studies have investigated CMR measurements of RV size to determine the optimal surgical indication for PVR (24)(25)(26)(27). Guidelines recommend RVEDVi > 160 mL/m2 or RVESVi > 80 mL/m2 as the optimal indications for asymptomatic rTOF patients (7,17,28).…”

Section: Preoperative Clinical Featuresmentioning

confidence: 99%

Right ventricular dilatation score: a new assessment to right ventricular dilatation in adult patients with repaired tetralogy of Fallot

Zhou¹,

Zhang²,

Han³

et al. 2023

Preprint

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Background: Patients with repaired tetralogy of Fallot (rTOF) experience long-term chronic pulmonary valve regurgitation resulting in right ventricular (RV) dilatation. According to current guidelines, the evaluation of patients with rTOF for RV dilatation should be based on cardiac magnetic resonance (CMR). However, for many asymptomatic patients, routine CMR is not practical. Our study aims to identify screening methods for CMR based on echocardiographic data, with the goal of establishing a more practical and cheap method of screening for severity of RV dilatation in patients with asymptomatic rTOF. Methods: 32 rTOF patients (mean age, 21(10.5) y, 21 males) with moderate to severe pulmonary regurgitation (PR) were prospectively recruited. Each patient received CMR and echocardiogram examination within 1 month prior to operation and collected clinical data, and then received echocardiogram examination at discharge and 3-6 months post-surgery. Results: RV moderate-severe dilatation was defined as right ventricular end-diastolic volume index (RVEDVI)≥160 ml/m2or right ventricular end-systolic volume index (RVESVI)≥80 ml/m2in 15 of 32 patients (RVEDVI, 202.15[171.51, 252.56] ml/m2, RVESVI, 111.99 [96.28, 171.74] ml/m2). The other 17 (RVESDI, 130.19 [117.91, 139.35] ml/m2, RVESVI= 67.91 [63.35, 73.11] ml/m2) were defined as right ventricle mild dilatation, i.e., RVEDVI<160ml/m2 and RVESVI<80 ml/m2, and the two parameters were higher than normal values. Compared with the RV mild dilatation group, patients of RV moderate-severe dilatation have worse cardiac function before surgery (right ventricular ejection fraction, 38.92(9.19) % versus 48.31(5.53) %, p<0.001; Left ventricular ejection fraction, 59.80(10.26) versus 66.41(4.15), p=0.021).Patients with RV moderate-severe dilatation faced longer operation time and more blood transfusion during operation (operation time, 271.53(08.33) min versus 170.53(72.36) min, p<0.01; Intraoperative blood transfusion, 200(175) ml versus 100(50) ml, p=0.001). Postoperative RV moderate-severe dilatation patients have poor short-term prognosis, which was reflected in a longer postoperative hospital stay (6.59 [2.12] days versus 9.80 [5.10] days, p=0.024) and a higher incidence of hypohepatia (0[0] % versus 4[26.7] %, p=0.023). Patients with RV dilatation score >2.35 were diagnosed with RV moderate-severe dilatation (AUC=0,882; Sensitivity =94.1%; Specificity =77.3%). Conclusions: RV moderate-severe dilatation is associated with worse preoperative cardiac function and short-term prognosis after PVR in rTOF patients with moderate to severe PR. The RV dilatation score is an effective screening method. When RV dilatation score>2.35, the patient is indicated for further CMR examination and treatment.

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CT and MRI for Repaired Complex Adult Congenital Heart Diseases

Cited by 11 publications

References 78 publications

Pulmonary Artery Stump Thrombus in a Patient With Remote History of Rastelli Procedure

Pulmonary Artery Stump Thrombus in a Patient With Remote History of Rastelli Procedure

Prevalence of Branch Pulmonary Artery Reintervention Following the Arterial Switch Operation

Right ventricular dilatation score: a new assessment to right ventricular dilatation in adult patients with repaired tetralogy of Fallot

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