Arterial Switch Procedure for D-Transposition of the Great Arteries: Quantitative Midterm Evaluation of Hemodynamic Changes with Cine MR Imaging and Phase-Shift Velocity Mapping—Initial Experience

Gutberlet, Matthias; Boeckel, Thomas P. Van; Hosten, Norbert; Vogel, Michael; Kühne, Titus; Oellinger, H.; Ehrenstein, T.; Venz, Stephan; Hetzer, Roland; Bein, G; Félix, R.

doi:10.1148/radiology.214.2.r00fe45467

Cited by 70 publications

(48 citation statements)

References 36 publications

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“…Both in vitro and in situ studies 21 have demonstrated close agreement between Doppler sonography, cardiac catheterization, and VEC MRI for quantification of vascular stenosis. It will be important to determine in future studies whether monitoring of flow through different stents can be used to detect and quantify stent stenosis.…”

Section: Discussionmentioning

confidence: 80%

Sequential Magnetic Resonance Monitoring of Pulmonary Flow With Endovascular Stents Placed Across the Pulmonary Valve in Growing Swine

et al. 2001

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Background-Patients with endovascular stent implantation for the treatment of right ventricular outflow tract obstruction are often left with incomplete relief of the obstruction and significant pulmonary regurgitation. A noninvasive and reproducible method for monitoring such patients is desirable. MRI in the presence of a stent, however, has to overcome the problem of potential metallic artifacts. Methods and Results-Under x-ray fluoroscopic guidance, endovascular nitinol stents were placed across the pulmonary valve in 6 young pigs to induce pulmonary regurgitation. Five additional pigs served as controls. Initial MRI was performed after 2 days (13.5Ϯ1.8 kg) and follow-up after 3 months (32Ϯ2.9 kg). Pulmonary flow volumes and regurgitant fraction were quantified by velocity-encoded cine (VEC) MRI through (VEC-TS) and distal to (VEC-DS) the stent. VEC-TS was compared with VEC-DS and volumetric measurements of left and right ventricular stroke volumes provided by cine MRI ("gold standard"). Antegrade and retrograde pulmonary flow volumes by VEC-TS were slightly but significantly less than those with VEC-DS and cine MRI. Excellent correlations (rϾ0.97) for phasic pulmonary flow volumes as measured by VEC-TS and VEC-DS were shown. Pulmonary regurgitant fraction increased from 32.8Ϯ15% to 49.6Ϯ17% (PϽ0.05) over the course of 3 months with VEC-TS. Conclusions-MRI demonstrates the progression of pulmonary regurgitation in growing swine. VEC MRI has the ability to quantify pulmonary blood flow inside the lumen of nitinol stents. MRI appears to be ideally suited for monitoring patients with endovascular nitinol stents in the pulmonary artery or pulmonary valve position.

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Section: Discussionmentioning

confidence: 80%

Sequential Magnetic Resonance Monitoring of Pulmonary Flow With Endovascular Stents Placed Across the Pulmonary Valve in Growing Swine

et al. 2001

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“…(27,28) Gd-MRA is used to visualize the 3D anatomy, particularly the relationship between the pulmonary arteries and the aorta, while spin-echo sequences are used to accurately assess sites of stenoses. It has been shown that this combination of techniques is superior to echocardiography and compares favorably with conventional X-ray angiography in detecting signifi cant lesions.…”

Section: Tetralogy Of Fallotmentioning

confidence: 99%

“…(28) A less common complication of the arterial switch procedure is coronary stenosis secondary to the reimplantation procedure. Although X-ray angiography represents the modality of choice, coronary MR angiography is particularly useful when assessing the proximal coronary arteries.…”

Section: Tetralogy Of Fallotmentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance in Congenital Heart Disease

Puranik

Muthurangu

Taylor

2017

SAHJ

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“…After the Lecompte maneuver, not only flattened anterior MPA (low-pressure), branch PA stenosis, and supravalvular PS at pulmonary bifurcation can occur as a consequence of posterior compression of MPA by the ascending aorta (Williams et al, 1997;Gutberlet et al, 2000); but also the aorta itself (systemic-pressure) may be compromised. Therfore, aortic neocaorctation was reported (Muster et al, 1987;Serraf et al, 1995).…”

Section: Commentmentioning

confidence: 99%

Restoration of Transposed Great Arteries With or Without Subpulmonary Obstruction to Nature

Chiu¹,

Hung²

2012

Front Lines of Thoracic Surgery

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Surgical correction on transposition of the great arteries was proposed by many in the past half-century, and was claimed as the anatomical correction; but the treatment of choice was ever changing. The current technique usually included Lecompte maneuver to bring the pulmonary bifurcation in front of the aorta. Although the ventriculoarterial connection was corrected, it is not "normal" yet---------.

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Arterial Switch Procedure for D-Transposition of the Great Arteries: Quantitative Midterm Evaluation of Hemodynamic Changes with Cine MR Imaging and Phase-Shift Velocity Mapping—Initial Experience

Abstract: The anatomic situation after arterial switch repair tended to produce temporary stenoses in the primary pulmonary arterial branches, with significant changes in hemodynamics. These changes may affect the long-term outcome and go undetected with other imaging modalities.

Cited by 70 publications

References 36 publications

Sequential Magnetic Resonance Monitoring of Pulmonary Flow With Endovascular Stents Placed Across the Pulmonary Valve in Growing Swine

Sequential Magnetic Resonance Monitoring of Pulmonary Flow With Endovascular Stents Placed Across the Pulmonary Valve in Growing Swine

The Role of Cardiovascular Magnetic Resonance in Congenital Heart Disease

Restoration of Transposed Great Arteries With or Without Subpulmonary Obstruction to Nature

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