Imaging of postoperative tetralogy of Fallot repair

Vaujois, Laurence; Gorincour, Guillaume; Alison, Marianne; Déry, Johanne; Poirier, Nancy; Lapierre, Chantale

doi:10.1016/j.diii.2016.02.007

Cited by 22 publications

(12 citation statements)

References 30 publications

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“…Thus, we might observe a combination of abnormal fiber orientations associated with the congenital condition and then modified by the evolving pathology. Further, the results of congenital cardiac surgery have improved significantly improved during the last five decades [ 3 , 59 ]. As a result, those cases in a single category (D-TGA for example) could represent a heterogeneous group with different surgical repair techniques affecting the microstructure.…”

Section: Discussionmentioning

confidence: 99%

Ex vivo cardiovascular magnetic resonance diffusion weighted imaging in congenital heart disease, an insight into the microstructures of tetralogy of Fallot, biventricular and univentricular systemic right ventricle

Tous

Gentles

Young

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Purpose Common types of congenital heart disease exhibit a variety of structural and functional variations which may be accompanied by changes in the myocardial microstructure. We aimed to compare myocardial architecture from magnetic resonance diffusion tensor imaging (DTI) in preserved pathology specimens. Materials and methods Pathology specimens (n = 24) formalin-fixed for 40.8 ± 7.9 years comprised tetralogy of Fallot (TOF, n = 10), dextro-transposition of great arteries (D-TGA, n = 8) five with ventricular septal defect (VSD), systemic right ventricle (n = 4), situs inversus totalis (SIT, n = 1) and levo-TGA (L-TGA, n = 1). Specimens were imaged using a custom spin-echo sequence and segmented automatically according to tissue volume fraction. In each specimen T1, T2, fractional anisotropy, mean diffusivity, helix angle (HA) and sheet angle (E2A) were quantified. Pathologies were compared according to their HA gradient, HA asymmetry and E2A mean value in each myocardial segment (anterior, posterior, septal and lateral walls). Results TOF and D-TGA with VSD had decreased helix angle gradient by − 0.34°/% and remained symmetric in the septum in comparison to D-TGA without VSD. Helix angle range was decreased by 45°. It was associated with a decreased HA gradient in the right ventricular (RV) wall, i.e. predominant circumferential myocytes. The sheet angle in the septum of TOF was opposing those of the left ventricular (LV) free wall. Univentricular systemic RV had the lowest HA gradient (− 0.43°/%) and the highest HA asymmetry (75%). HA in SIT was linear, asymmetric, and reversed with a sign change at about 70% of the depth at mid-ventricle. In L-TGA with VSD, HA was asymmetric (90%) and its gradients were decreased in the septum, anterior and lateral wall. Conclusion The organization of the myocytes as determined by DTI differs between TOF, D-TGA, L-TGA, systemic RV and SIT specimens. These differences in cardiac structure may further enlighten our understanding of cardiac function in these diverse congenital heart diseases.

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Section: Discussionmentioning

confidence: 99%

Ex vivo cardiovascular magnetic resonance diffusion weighted imaging in congenital heart disease, an insight into the microstructures of tetralogy of Fallot, biventricular and univentricular systemic right ventricle

Tous

Gentles

Young

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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“…Tetralogy of Fallot is a cyanotic congenital heart disease [14] and requires corrective surgery early in life to improve long-term survival [4]. CMR is the method of choice for assessing pre-operative parameters in RTOF [15, 16]. Exercise tests on patients with RTOF are possible [17], but very few studies on RTOF patients’ response to exercise have measured bi-ventricular parameters [18, 19], and, to the best of our knowledge, none has explored aortic compliance (AC).…”

Section: Introductionmentioning

confidence: 99%

Exercise stress CMR reveals reduced aortic distensibility and impaired right-ventricular adaptation to exercise in patients with repaired tetralogy of Fallot

et al. 2018

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BackgroundThe aim of our study was to evaluate the feasibility of exercise cardiac magnetic resonance (CMR) in patients with repaired tetralogy of Fallot (RTOF) and to assess right and left ventricular adaptation and aortic wall response to exercise in comparison with volunteers.Methods11 RTOF and 11 volunteers underwent prospective CMR at rest and during exercise. A supine bicycle ergometer was employed to reach twice the resting heart rate during continuous exercise, blood pressure and heart rate were recorded. Bi-ventricular parameters and aortic stiffness were assessed using accelerated cine sequences and flow-encoding CMR. A t-test was used to compare values between groups. A Mann Whitney test was used to compare values within groups.ResultsIn RTOF both ventricles showed an impaired contractile reserve (RVEF rest 36.2±8.3%, +1.3±3.9% increase after exercise; LVEF rest 53.8±6.1%, +5.7±6.4% increase after exercise) compared to volunteers (RVEF rest 50.5±5.0%, +10.4±7.1% increase after exercise, p = 0.039; LVEF rest 61.9±3.1%, +12.2±4.7% increase after exercise, p = 0.014).RTOF showed a reduced distensibility of the ascending aorta during exercise compared to volunteers (RTOF: 3.4±1.9 10-3.mmHg-1 vs volunteers: 5.1±1.4 10-3.mmHg-1; p = 0.027). Ascending aorta distensibility was correlated to cardiac work in the volunteers but not in RTOF.ConclusionRTOF showed an impaired contractile reserve for both ventricles. The exercise unmasked a reduced distensibility of the ascending aorta in RTOF, which may be an early sign of increased aortic rigidity.

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“…MRI using a phase-contrast pulse sequence is regarded as a standard for quantifying pulmonary regurgitation (25). The pulmonary regurgitant fraction is calculated as the retrograde flow volume divided by the antegrade flow volume (Fig.…”

Section: Pulmonary Regurgitationmentioning

confidence: 99%

“…In contrast, residual or recurrent branch pulmonary artery stenosis evaluated on CT or MRI increases net pulmonary regurgitation ( Fig. 7) (18,25).…”

Section: Pulmonary Regurgitationmentioning

confidence: 99%

CT and MRI for Repaired Complex Adult Congenital Heart Diseases

Siripornpitak

Goo

2021

Korean J Radiol

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Advances in the diagnosis and treatment of pediatric congenital heart disease have resulted in improved survival rates, with many repaired patients reaching adulthood. In cases of adult congenital heart disease (ACHD), patients typically undergo palliative and/or corrective treatment with either a surgical, interventional, or hybrid procedure. The resultant changes in the cardiovascular anatomy and physiology are subject to long-term imaging followup to ensure adaptive responses and identify potential complications early on. The recommended frequency and modality for imaging follow-up is based on the underlying disease, mode of correction, and functional status as well as strengths and weaknesses of each modality (1).

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Imaging of postoperative tetralogy of Fallot repair

Cited by 22 publications

References 30 publications

Ex vivo cardiovascular magnetic resonance diffusion weighted imaging in congenital heart disease, an insight into the microstructures of tetralogy of Fallot, biventricular and univentricular systemic right ventricle

Ex vivo cardiovascular magnetic resonance diffusion weighted imaging in congenital heart disease, an insight into the microstructures of tetralogy of Fallot, biventricular and univentricular systemic right ventricle

Exercise stress CMR reveals reduced aortic distensibility and impaired right-ventricular adaptation to exercise in patients with repaired tetralogy of Fallot

CT and MRI for Repaired Complex Adult Congenital Heart Diseases

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