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Bohnen MS, Nallamothu BK, Zilinyi R, Saint S, Slater ED. A Wrong Turn. N Engl J Med 2023; 388:2087-2093. [PMID: 37256979 DOI: 10.1056/nejmcps2215388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Michael S Bohnen
- From the Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York (M.S.B., R.Z., E.D.S.); and the Department of Internal Medicine, University of Michigan, and the Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System - both in Ann Arbor (B.K.N., S.S.)
| | - Brahmajee K Nallamothu
- From the Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York (M.S.B., R.Z., E.D.S.); and the Department of Internal Medicine, University of Michigan, and the Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System - both in Ann Arbor (B.K.N., S.S.)
| | - Robert Zilinyi
- From the Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York (M.S.B., R.Z., E.D.S.); and the Department of Internal Medicine, University of Michigan, and the Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System - both in Ann Arbor (B.K.N., S.S.)
| | - Sanjay Saint
- From the Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York (M.S.B., R.Z., E.D.S.); and the Department of Internal Medicine, University of Michigan, and the Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System - both in Ann Arbor (B.K.N., S.S.)
| | - Emily D Slater
- From the Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York (M.S.B., R.Z., E.D.S.); and the Department of Internal Medicine, University of Michigan, and the Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System - both in Ann Arbor (B.K.N., S.S.)
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2
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Venet M, Friedberg MK, Mertens L, Baranger J, Jalal Z, Tlili G, Villemain O. Nuclear Imaging in Pediatric Cardiology: Principles and Applications. Front Pediatr 2022; 10:909994. [PMID: 35874576 PMCID: PMC9301385 DOI: 10.3389/fped.2022.909994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Nuclear imaging plays a unique role within diagnostic imaging since it focuses on cellular and molecular processes. Using different radiotracers and detection techniques such as the single photon emission scintigraphy or the positron emission tomography, specific parameters can be assessed: myocardial perfusion and viability, pulmonary perfusion, ventricular function, flow and shunt quantification, and detection of inflammatory processes. In pediatric and congenital cardiology, nuclear imaging can add complementary information compared to other imaging modalities such as echocardiography or magnetic resonance imaging. In this state-of-the-art paper, we appraise the different techniques in pediatric nuclear imaging, evaluate their advantages and disadvantages, and discuss the current clinical applications.
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Affiliation(s)
- Maelys Venet
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Mark K. Friedberg
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jerome Baranger
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Zakaria Jalal
- Department of Congenital and Pediatric Cardiology, Hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux-Pessac, France
| | - Ghoufrane Tlili
- Department of Nuclear Medicine, Hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux-Pessac, France
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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3
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Goerne H, de la Fuente D, Cabrera M, Chaturvedi A, Vargas D, Young PM, Saboo SS, Rajiah P. Imaging Features of Complications after Coronary Interventions and Surgical Procedures. Radiographics 2021; 41:699-719. [PMID: 33798007 DOI: 10.1148/rg.2021200147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Coronary artery interventions and surgical procedures are used in the treatment of coronary artery disease and some congenital heart diseases. Cardiac and noncardiac complications can occur at variable times after these procedures, with the clinical presentation ranging from asymptomatic to devastating symptoms. Invasive coronary angiography is the reference standard modality used in the evaluation of coronary arteries, with intravascular US and optical coherence tomography providing high-resolution information regarding the vessel wall. CT is the mostly commonly used noninvasive imaging modality in the evaluation of coronary artery intervention complications and allows assessment of the stent, lumen of the stent, lumen of the coronary arteries, and extracoronary structures. MRI is limited to the evaluation of the proximal coronary arteries but allows comprehensive evaluation of the myocardium, including ischemia and infarction. The authors review the clinical symptoms and pathophysiologic and imaging features of various complications of coronary artery interventions and surgical procedures. Complications of percutaneous coronary interventions are discussed, including restenosis, thrombosis, dissection of coronary arteries or the aorta, coronary wall rupture or perforation, stent deployment failure, stent fracture, stent infection, stent migration or embolism, and reperfusion injury. Complications of several surgical procedures are reviewed, including coronary artery bypass grafting, coronary artery reimplantation procedure (for anomalous origin from opposite sinuses or the pulmonary artery or as part of surgical procedures such as arterial switching surgery and the Bentall and Cabrol procedures), coronary artery unroofing, and the Takeuchi procedure. Online supplemental material is available for this article. ©RSNA, 2021.
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Affiliation(s)
- Harold Goerne
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Diego de la Fuente
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Miguel Cabrera
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Abhishek Chaturvedi
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Daniel Vargas
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Phillip M Young
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Sachin S Saboo
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
| | - Prabhakar Rajiah
- From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.)
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Hirai T, Jacob D, Main ML, Grantham JA. A case of robotic assisted percutaneous coronary intervention of the left main coronary artery in a patient with very late baffle stenosis after surgical correction of anomalous left coronary artery from the pulmonary artery. Catheter Cardiovasc Interv 2020; 95:920-923. [PMID: 31250510 DOI: 10.1002/ccd.28382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/03/2019] [Accepted: 06/17/2019] [Indexed: 11/09/2022]
Abstract
A 34-year-old woman with history of surgical correction (Takeuchi procedure) of anomalous left coronary artery from the pulmonary artery (ALCAPA) presented with reduced left ventricular ejection fraction of 48% and severe ischemia quantified as 21% by stress Positron Emission Tomography (PET) scan. A coronary angiogram revealed ostial 90% stenosis of the left main coronary artery (LMCA). A guidewire (Sion Blue, Asahi Intecc USA, Inc., Santa Ana, CA) was navigated robotically and after pre-dilation with 3.5 × 15 mm cutting balloon, the lesion length was measured by marking the distal end of the lesion with the balloon marker and withdrawing back robotically to the ostium of the LMCA. A 3.5 × 16 mm drug-eluting stent was deployed robotically after intravascular ultrasound (IVUS) with good results. The main advantage of robotic percutaneous coronary intervention includes the precise measurement and positioning of the stent. Since the guide catheter and balloon can be adjusted without guide catheter and device interaction, precise placement of stent is possible by advancing the device distal to the lesion, positioning the guide catheter just proximal to the proximal edge of the stent and pulling the guidecatheter and device back as a unit. Final IVUS after post-dilation with 4.0 noncompliant and 5.0 compliant balloon revealed precise placement at the ostium and full stent expansion.
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Affiliation(s)
- Taishi Hirai
- Department of Medicine, Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.,Department of Medicine, Division of Cardiology, University of Missouri Kansas City, Kansas City, Missouri
| | - Dany Jacob
- Department of Medicine, Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.,Department of Medicine, Division of Cardiology, University of Missouri Kansas City, Kansas City, Missouri
| | - Michael L Main
- Department of Medicine, Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.,Department of Medicine, Division of Cardiology, University of Missouri Kansas City, Kansas City, Missouri
| | - J Aaron Grantham
- Department of Medicine, Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.,Department of Medicine, Division of Cardiology, University of Missouri Kansas City, Kansas City, Missouri
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Lin S, Xie M, Lv Q, Wang J, He L, Wang B, Li Y, Xu L, Yang Y. Misdiagnosis of anomalous origin of the left coronary artery from the pulmonary artery by echocardiography: Single-center experience from China. Echocardiography 2020; 37:104-113. [PMID: 31981242 DOI: 10.1111/echo.14578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/26/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To identify the risk factors causing misdiagnosis by echocardiography and missed diagnosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). MATERIALS AND METHODS Echocardiographic results of 16 patients with ALCAPA confirmed by surgery in Union Hospital, Wuhan, were analyzed retrospectively. The influencing factors leading to echocardiographic misdiagnosis were analyzed from the aspects of confusing image characteristics, special pathological anatomy of the left coronary artery (LCA), and operators' working years. RESULTS Echocardiography diagnosed 11 cases with an accuracy rate of 68.8%. Five cases were misdiagnosed, three cases as endocardial fibroelastosis, one case as mitral prolapse with severe insufficiency, and one case as coronary-pulmonary artery fistula. Display rate of the specific echocardiographic features for confirmed group and misdiagnosed group was statistically significantly different(P = .014). But the working years of the operator for confirmed group and misdiagnosed group were not statistically significantly different(P = .267). Some special pathological anatomy and pathophysiological features could be also the cause of misdiagnosis. CONCLUSIONS Echocardiography is the first diagnostic choice of the ALCAPA in China. It is essential for the operator to have the knowledge, diagnostic awareness, and proficiency in manipulation in the accurate interpretation of echocardiography results.
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Affiliation(s)
- Shan Lin
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Qing Lv
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Jing Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Lin He
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Bin Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuman Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Lingling Xu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yali Yang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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