Efficacy of Three-Dimensional Rotational Angiography as a Diagnostic and Interventional Modality for Congenital Heart Disease

Abstract

Background: Lesions of congenital heart disease require stereoscopic understanding, which can be enhanced by three dimensional imaging. In Shizuoka Children s Hospital, three-dimensional rotational angiography (3DRA) is in use since 2013. Purpose: To report the efficacy of 3DRA in congenital heart disease. Objective and Methods: We evaluated the advantage of 3DRA in 24 patients. Secondly, we reviewed 15 patients who had a single target lesion in the pulmonary artery after Rastelli procedure, visualized on 3DRA (n=5) or CT (n=10) at the time of intervention, between 2010 and 2016. Procedural parameters were compared between the two groups. Results: All reconstructed 3DRA images provided adequate diagnostic quality and by Likert scale, classified as either essential or very useful for pre-operative or interventional planning in 75% of patients, especially in complex vascular lesions. No complications occurred. There was no significant difference with respect to procedure time, fluoroscopy time, radiation dose of angiography between 3DRA and CT. Total contrast media used in 3DRA group (3.9mL/kg) was significantly lower than that in the CT group (5.9mL/kg; p=0.003). Conclusions: 3DRA is a safe and effective modality in pediatric cardiovascular area. Wide-angled, stereoscopic image reconstruction allows for a more objective evaluation. Use of 3DRA was comparable to that of CT with respect to procedure time, fluoroscopy time, and radiation dose. Total contrast media used was significantly less in the former.