Different CMR Imaging Modalities for Native and Patch-Repaired Right Ventricular Outflow Tract Sizing: Impact on Percutaneous Pulmonary Valve Replacement Planning

Ferrari, Irene; Shehu, Nerejda; Mkrtchyan, Naira; Martinoff, Stefan; Eicken, Andreas; Stern, Heiko; Ewert, Peter; Meierhofer, Christian

doi:10.1007/s00246-019-02270-5

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…[6][7][8][9]17 However, the use of this advanced cardiac imaging to determine which palliative methodology is employed in individual patients remains very limited. [10][11][12] Given the vast array of right ventricular outflow tract morphologies necessitating pulmonary valve replacement, [18][19][20][21] calculating perimeter may prove more clinically beneficial than traditional measurements such as two-dimensional diameters. As outlined above, no transcatheter pulmonary valve replacement patient demonstrated a landing zone perimeter larger than 101.8 mm (circularised diameter 32 mm), and no surgical/hybrid patient had one smaller than 95.1 mm.…”

Section: Discussionmentioning

confidence: 99%

“…6-9,17 However, the use of this advanced cardiac imaging to determine which palliative methodology is employed in individual patients remains very limited. 10-12…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9] However, only a few advanced imaging reports have centred attention on how to determine best measurements to assess candidacy for available transcatheter pulmonary valve when indicated. [10][11][12] At our centre, right ventricular outflow tract intervention has evolved to encompass transcatheter, surgical, or hybrid palliative methodologies. 13 The latter includes off-bypass surgical plication, then subsequent transcatheter pulmonary valve replacement.…”

Section: Introductionmentioning

confidence: 99%

“…6-9 However, only a few advanced imaging reports have centred attention on how to determine best measurements to assess candidacy for available transcatheter pulmonary valve when indicated. 10-12…”

mentioning

confidence: 99%

“…Several methodologies have been outlined in the literature attempting to predict candidacy for transcatheter replacement by MRI 10,14 or CT angiography. 15,16 These efforts have focused on diameter measurements from advanced imaging during different phases of the cardiac cycle or extrapolating risk of coronary compression based on proximity of the coronary arteries.…”

mentioning

confidence: 99%

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Right ventricular outflow tract landing zone perimeter / circularised diameter – new imaging standards in pulmonary valve replacement reporting

Ligon

Latson²,

Ruzmetov³

et al. 2022

Cardiol Young

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Background: Right ventricular outflow tract intervention spans transcatheter, surgical, or hybrid pulmonary valve replacement methodologies. Standardised pre-procedure workup includes cardiac MRI to identify an intended valve site (landing zone). Our institutional practice includes measurement of the right ventricular outflow tract perimeter (circumference) of this site in end-systole. Our primary aim was to compare patients by their perimeter values to the palliative interventions performed (transcatheter versus surgical/hybrid methodologies). Methods: Retrospective review of patients undergoing pulmonary valve replacement from January 2017 to 2021. We performed perimeter measurements at the intended valve site on advanced imaging; the outcomes of interventions were outlined via descriptive and statistical analyses. Results: A total of 37 patients underwent pulmonary valve replacement that met study criteria – 21 transcatheter, 7 surgical, and 9 hybrid. Median age at intervention was 26 years (range 8–70). The mean end-systolic perimeter of the transcatheter cohort was 88.9 ± 8.7 mm and in the surgical/hybrid cohort measured 106.6 ± 7.5 mm. For the transcatheter cohort, the median “circularised” diameter derived from the perimeter measurement (divided by π) was 27.7 mm (range 24.3–32.4). Notably, this correlated (r = 0.93, p < 0.01) with the median diameter of the narrowest region during actual transcatheter right ventricular outflow tract balloon sizing (lateral imaging) of 27.1 mm (range 23.2–30.1). Conclusions: Right ventricular outflow tract perimeter measurement to determine circularised diameter is useful in planning pulmonary valve replacement in terms of candidacy of transcatheter versus the need for a surgical/hybrid approach. The circularised diameter correlates with transcatheter right ventricular outflow tract balloon sizing.

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Section: Discussionmentioning

confidence: 99%

“…6-9,17 However, the use of this advanced cardiac imaging to determine which palliative methodology is employed in individual patients remains very limited. 10-12…”

Section: Discussionmentioning

confidence: 99%