Non-invasive Imaging in the Evaluation of Cardiac Shunts for Interventional Closure

Abstract

Multimodality imaging provides important information to guide patient selection and pre-procedural decision making for shunt lesions in CHD. While echocardiography, CT, and CMR are well-established, 3D printing and now virtual reality imaging are beginning to show promise.

Patent ductus arteriosus: An unexpected diagnosis in adulthood

“…Additional imaging methods, such as CMR, are useful to confirm the diagnosis and to determine the magnitude of the shunt. Right cardiac catheterization is not mandatory for diagnostic purposes, but it is essential to assess the presence and degree of pulmonary hypertension and to calculate pulmonary vascular resistance, which can constitute a contraindication to closing the shunt [1,2]. Our patient was not cyanotic, and he showed no clubbing of his toes; otherwise, a suspicion of Eisenmenger's syndrome should be raised.…”

“…PDA, a congenital heart defect, is considered abnormal when it persists into adulthood, and its clinical impact depends on its size, pulmonary-to-systemic-flow ratio, and underlying cardiac conditions [1]. In late adulthood, PDA is a rare diagnosis and represents an incidental finding suggested by physical examination and confirmed by TTE [2]. Additional imaging methods, such as CMR, are useful to confirm the diagnosis and to determine the magnitude of the shunt.…”

OUP accepted manuscript

“…The increasing role of VR in determining individual threshold or need for intervention as well as assessing suitability for intervention has been recently reviewed. 50 Another approach is the simulation of transcatheter CHD interventions in VR. Nam et al 51 developed a method allowing virtual 'testing' of device placements in multiple cardiac phases rather than inferring adequate fit from 2D measurements.…”