Objectives We validated a novel image-based motion estimation CT technique (iME) to quantify atrial regional function in swine in vivo. Methods Domestic swine (n=8) underwent CT scan with intravenous contrast before and after median sternotomy where 15–30 glass beads were sutured to the atria to calculate the motion estimation error. Four-dimensional motion vector field (MVF) was estimated using iME. Area change ratio (%AC) was calculated over the atrial endocardium to assess the surface deformation. Results The error between the measured and the calculated coordinates based on MVF was 0.76±0.43 mm. %AC was regionally heterogeneous. %AC time course was significantly different between the right and the left atrium (P<0.001), and between the right atrial appendage and the right atrial chamber (P=0.004). Conclusions Quantitative assessment of atrial regional function using iME is highly accurate. iME can quantify subtle regional dysfunction that is not apparent in global functional indices such as ejection fraction.

A subset of patients with severe airway disease cannot be adequately supported with conventional mechanical ventilation during complex airway procedures. We report the first successful respiratory support of a patient with severe tracheobronchomalacia with veno-venous extracorporeal membrane oxygenation during rigid bronchoscopy with stent removal and stent placement.