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Management of patients with single ventricle physiology across the lifespan: contributions from magnetic resonance and computed tomography imaging. Can J Cardiol 2022; 38:946-962. [DOI: 10.1016/j.cjca.2022.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/27/2021] [Accepted: 01/02/2022] [Indexed: 12/12/2022] Open
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El-Sabrout HR, Ryan JR, Hegde SR, El-Said HG, Nigro JJ, Moore JW, Ratnayaka K. Purpose-built transcatheter cavopulmonary anastomosis device requirements: Multi-modality imaging evaluation. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 34:128-133. [PMID: 33526391 DOI: 10.1016/j.carrev.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND/PURPOSE Patients with a functional single ventricle undergo multiple, palliative open-heart surgeries. This includes a superior cavopulmonary anastomosis or bidirectional Glenn shunt. A less-invasive transcatheter approach may reduce morbidity. METHODS/MATERIALS We analyzed pre-Glenn X-ray contrast angiography (XA), cardiac computed tomography (CT), and cardiac magnetic resonance (CMR) studies. RESULTS Over an eleven-year period (1/2007 - 6/2017), 139 Glenn surgeries were performed at our institution. The typical age range at surgery was 59 - 371 days (median = 163; IQR = 138 - 203). Eight-nine XA, ten CT, and ten CMR studies obtained from these patients were analyzed. Cephalad SVC measurements (millimeters) were 7.3 ± 1.7 (XA), 7.7 ± 1.6 (CT) and 6.9 ± 1.8 (CMR). RPA measurements were 7.3 ± 1.9 (XA), 7.4 ± 1.6 (CT) and 6.6 ± 1.9 (CMR). Potential device lengths were 10.9 ± 6 - 17.4 ± 6.4 (XA), 10.1 ± 2.1 - 17.7 ± 2.4 (CT) and 17.3 ± 4. - 23.7 ± 5.5 (CMR). SVC-RPA angle (degrees) was 132.9 ± 13.2 (CT) and 140 ± 10.2 (MRI). Image quality of all CT (100%), almost all XA (SVC 100%, RPA 99%), and most MRI (SVC 80%, RPA 90%) were deemed sufficient. Parametric modeling virtual fit device with 10 mm diameter and 20 - 25 mm length was ideal. CONCLUSIONS Ideal transcatheter cavopulmonary shunt device for the typical patient would be 10 mm in diameter and 20-25 mm in length.
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Affiliation(s)
- Hannah R El-Sabrout
- Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA
| | - Justin R Ryan
- Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA; Division of Cardiovascular Surgery, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA
| | - Sanjeet R Hegde
- Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA
| | - Howaida G El-Said
- Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA
| | - John J Nigro
- Division of Cardiovascular Surgery, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA
| | - John W Moore
- Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA
| | - Kanishka Ratnayaka
- Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020 Children's Way, San Diego, CA, USA.
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Krupickova S, Vazquez-Garcia L, Obeidat M, Banya W, DiSalvo G, Ghez O, Michielon G, Castellano I, Rubens M, Semple T, Nicol E, Slavik Z, Rigby ML, Fraisse A. Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings. Arch Cardiovasc Dis 2019; 112:12-21. [DOI: 10.1016/j.acvd.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/11/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
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Krupickova S, Muthurangu V, Hughes M, Tann O, Carr M, Christov G, Awat R, Taylor A, Marek J. Echocardiographic arterial measurements in complex congenital diseases before bidirectional Glenn: comparison with cardiovascular magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2018; 18:332-341. [PMID: 27099275 DOI: 10.1093/ehjci/jew069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/08/2016] [Indexed: 11/13/2022] Open
Abstract
Aims This study sought to investigate diagnostic accuracy of echocardiographic measures of great vessels in patients before bidirectional cavopulmonary connection (BCPC) compared with cardiovascular magnetic resonance (CMR). Methods and results Seventy-two patients (61% after Norwood operation) undergoing BCPC between 2007 and 2012 were assessed pre-operatively using echocardiography and CMR. Bland-Altman analysis and correlation coefficients were used for comparison of echocardiography and CMR measurements. Sensitivity, specificity, and positive and negative predictive values were calculated to assess the ability of echocardiography to detect vessel stenosis. Twenty-four percent of all vessel measurements could not be made by echocardiography due to poor image quality. Acquisition of unsatisfactory images was higher in non-sedated patients. Although there was a reasonable correlation (0.68-0.90) and low bias (-0.8 to 0.5), there were wide limits of agreement between echocardiography and CMR demonstrating poor agreement. Sensitivity and specificity for pulmonary branches were moderate [sensitivity for right pulmonary artery (RPA) 67%, left pulmonary artery (LPA) 54%, specificity for RPA 65%, LPA 72%] with low levels of accuracy (RPA and LPA 42%). Sensitivity, specificity, and accuracy were better for aorta (82, 86, and 63%, respectively). Conclusion This study demonstrates modest agreement between echocardiographic and CMR measures of vessel diameter and stenosis detection. Approximately a quarter of all vessel segments could not be measured using echocardiography due to poor image quality, which was significantly lower in non-sedated patients. These findings show that echocardiography cannot substitute CMR for reliable identification of great vessel stenoses in complex patients prior to the BCPC, particularly those with Blalock-Taussig shunts.
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Affiliation(s)
- Sylvia Krupickova
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Vivek Muthurangu
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.,Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science London, London, UK
| | - Marina Hughes
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Oliver Tann
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Michelle Carr
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Georgi Christov
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Ram Awat
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Andrew Taylor
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.,Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science London, London, UK
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.,Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science London, London, UK
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