Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging.

Steffens, Johann C.; Bourne, Michael W.; Sakuma, Hajime; O’Sullivan, Margaret; Higgins, Charles B.

doi:10.1161/01.cir.90.2.937

Cited by 184 publications

(105 citation statements)

References 26 publications

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“…Other groups have focused on the percent increase in descending aorta flow from collateral vessels to assess coarctation severity. 29 Steffens et al 30 reported that the percent increase in flow correlated with the diameter of the coarctation segment (rϭ0.94), with arm-toleg blood pressure difference (rϭ0.84), and with Doppler gradient (rϭ0.76). More recently, Araoz and colleagues 9 demonstrated that the percent increase in descending aorta flow in 19 patients with repaired CoA more accurately reflected the degree of narrowing than arm-to-leg blood pressure measurements.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Predictors of Coarctation Severity

et al. 2005

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Background-MRI is increasingly used for anatomic assessment of aortic coarctation (CoA), but its ability to predict the transcatheter pressure gradient, considered the reference standard for hemodynamic severity, has not been studied in detail. This study evaluated the ability of MRI to distinguish between mild versus moderate and severe CoA as determined by cardiac catheterization. Methods and Results-The clinical, MRI, and catheterization data of 31 subjects referred for assessment of native or recurrent CoA were reviewed retrospectively. Patients were divided into 2 groups on the basis of peak coarctation gradient by catheterization: Ͻ20 mm Hg (nϭ12) and Ն20 mm Hg (nϭ19). Patients with cardiac index Ͻ2.2 L · min

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Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Predictors of Coarctation Severity

et al. 2005

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“…More recently, with the development of contrast-enhanced MRA, this technique has replaced conventional angiography in the diagnosis of aortic coarctation. MR not only provides excellent morphologic images but also can be used to document hemodynamic significance (1,(3)(4)(5)(6). This approach for assessing coarctation severity is based upon measuring the flow in the distal aorta above the diaphragm and comparing it to the flow measured below the coarctation site (1,4).…”

Section: Discussionmentioning

confidence: 99%

“…However, only recently has collateral flow been noninvasively quantified. Phase-contrast MR imaging (PC-MR) has been recognized to be a feasible method for assessing coarctation severity by quantifying collateral flow (1,(3)(4)(5)(6). This approach is based on measuring aortic flow in the distal aorta near the diaphragm and at a more proximal site just below the coarctation (5).…”

mentioning

confidence: 99%

Phase contrast MR imaging to measure changes in collateral blood flow after stenting of recurrent aortic coarctation: Initial experience

Pujadas

Reddy

Weber

et al. 2006

Magnetic Resonance Imaging

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Purpose:To assess the feasibility of using phase contrast magnetic resonance (PC-MR) imaging to measure the change in collateral blood flow early after stenting of aortic coarctation. Materials and Methods:A total of 10 consecutive patients with coarctation of the aorta underwent MR imaging, X-ray angiography, and stent placement. PC-MR at two sites in the descending aorta was performed before and early after stenting in order to estimate collateral inflow to the descending thoracic aorta. The collateral flow and collateral flow percentage before and after stent placement were compared.Results: Before stenting, the mean proximal aortic flow ϭ 43.9 Ϯ 14.6 mL/second; mean distal flow ϭ 54.2 Ϯ 10 mL/second; collateral flow ϭ 10.2 Ϯ 6.8 mL/second; and collateral flow percentage ϭ 30.1 Ϯ 27.9%. After stenting, the mean proximal aortic flow ϭ 62.1 Ϯ 17.9 mL/second; mean distal flow ϭ 60 Ϯ 19 mL/second; collateral flow ϭ -1.9 Ϯ 3.7 mL/second; and collateral flow percentage ϭ -3.3 Ϯ 6.8%. Conclusion:PC-MR can be used to measure changes in collateral circulation after stent treatment of coarctation of the aorta.

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“…Patients with less severe coarctation may not be diagnosed until later in childhood when a murmur is heard or hypertension noted. In these patients, collateral vessels develop from the internal thoracic and subclavian arteries, thyrocervical trunks, and vertebral and anterior spinal arteries to supply blood to the descending aorta [21,22] . For those who enter adulthood undiagnosed, hypertension is the most common presenting symptom [23] .…”

Section: Clinical Presentationmentioning

confidence: 99%

Coarctation of the aorta: Management from infancy to adulthood

Török

Campbell

Fleming

et al. 2015

WJC

233

151

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Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

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Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging.

Cited by 184 publications

References 26 publications

Magnetic Resonance Imaging Predictors of Coarctation Severity

Magnetic Resonance Imaging Predictors of Coarctation Severity

Phase contrast MR imaging to measure changes in collateral blood flow after stenting of recurrent aortic coarctation: Initial experience

Coarctation of the aorta: Management from infancy to adulthood

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