The role of cardiac MRI in the diagnosis and management of sinus venosus atrial septal defect

Ganigara, Madhusudan; Tanous, David; Celermajer, David S.; Puranik, Rajesh

doi:10.4103/0974-2069.132509

Cited by 12 publications

(6 citation statements)

References 8 publications

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“…It should be noted that TEE is the diagnostic procedure of choice because of close proximity of atrial septum to TEE transducer . However, it may not constantly reveal detailed information about anatomical and functional charactrizations and this type of defect can be misleading . This is what happened in the present patient, since previous TEEs could not reveal IVC overriding.…”

Section: Discussionmentioning

confidence: 58%

“…Contrast‐enhanced computed tomography scan (CT scan) is another valuable modality that can be utilized even though it involves exposure to ionizing radiation and sometimes fails to reveal sufficient information. Cardiac MRI is an ideal imaging modality which can precisely determine ventricular volumes, degree of left‐to‐right shunts, as well as abnormalities of pulmonary venous connection . The patient in the present report had previously undergone an MRI showing significant left‐to‐right shunt, but did not diagnose ASD.…”

Section: Discussionmentioning

confidence: 77%

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Undiagnosed inferior vena cava type of sinus venosus atrial septal defect in a middle‐aged woman: A rare case report

Ghaemian

Nabati

Shokri

2019

J of Clinical Ultrasound

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Sinus venosus atrial septal defect (ASD) accounts for 5% to 10% of ASDs. In contrast with the more common superior vena cava (SVC) type, the inferior vena cava (IVC) type of sinus venosus ASD with overriding IVC is extremely rare. The sinus venosus defect occur posterior to the fossa ovalis and is not regarded as true ASD. Transesophageal echocardiography (TEE) is a diagnostic procedure of choice due to close proximity of atrial septum to TEE transducer. However; it may not constantly yield detailed anatomical and functional characterization, and other imaging modalities such as cardiac magnetic resonance imaging (MRI) may be needed. We report the case of a 45-year-old woman with an undiagnosed hemodynamically significant IVC-type ASD without any anomalous drainage of pulmonary veins, who presented with progressive dyspnea. K E Y W O R D S echocardiography, magnetic resonance imaging, patent foramen ovale, sinus venosus defect

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 77%

Undiagnosed inferior vena cava type of sinus venosus atrial septal defect in a middle‐aged woman: A rare case report

Ghaemian

Nabati

Shokri

2019

J of Clinical Ultrasound

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“…In paediatric surgery, the application of TOE can be more difficult in adults. Cardiac CT or MRI can be alternative diagnostic tools; 4 however, they also have some limitations. Children might require general anaesthesia for these imaging modalities.…”

Section: Discussionmentioning

confidence: 99%

Complications caused by iatrogenic right-to-left shunt after surgical closure of atrial septal defect: a case report

Kim

Jang

Yang

2021

European Heart Journal - Case Reports

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Background Atrial septal defect (ASD) is a common congenital heart disease. For this condition, surgical treatment can be required depending on the size and type of ASD. This study included a case of a patient who complained of persistent dyspnoea after the surgical treatment for ASD. Case summary A 16-year-old girl who underwent a surgical patch closure for ASD at the age of 2 years presented to the emergency department and was diagnosed with acute stroke. Since childhood, she had suffered from exertional dyspnoea due to an unknown cause. Transthoracic echocardiography revealed normal chambers size and function and no signs of right heart strain. Transoesophageal echocardiography (TOE) revealed a misplaced interatrial patch from the previous surgery, which allowed the whole blood to flow from the inferior vena cava (IVC) to the left atrium (LA), creating a large right-to-left shunt that resulted in stroke and heart failure. The patient underwent surgical treatment, and her symptoms improved significantly. Six months later, she was doing well without neurological complications and dyspnoea. Discussion This patient experienced stroke at the age of 16 years and had been suffering from heart failure since childhood. A large right-to-left shunt flow from the IVC to the LA by misplaced interatrial patch was found using TOE, right-sided heart catheterization, and inferior caval venography. This diagnosis should be considered in patients complaining of persistent dyspnoea with hypoxia after the surgical repair of ASD.

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“…9 Although TTE can also evaluate parameters of right ventricular performance, the absence of tricuspid regurgitation or presence of severe tricuspid regurgitation can limit the accuracy of mPAP estimations. 10 Cardiac magnetic resonance imaging (MRI) is increasingly utilized to evaluate a wide variety of cardiovascular diseases [11][12][13] and has shown promise in the evaluation of PH. [14][15][16] Four-dimensional (4D) flow MRI is a relatively new MRI technique that can provide a comprehensive qualitative and quantitative assessment of vascular hemodynamics and has been utilized to assess many different cardiovascular diseases including PH.…”

mentioning

confidence: 99%

“…Cardiac magnetic resonance imaging (MRI) is increasingly utilized to evaluate a wide variety of cardiovascular diseases 11–13 and has shown promise in the evaluation of PH 14–16 . Four‐dimensional (4D) flow MRI is a relatively new MRI technique that can provide a comprehensive qualitative and quantitative assessment of vascular hemodynamics and has been utilized to assess many different cardiovascular diseases including PH 17 .…”

mentioning

confidence: 99%

Evaluation of Pulmonary Hypertension Using 4D Flow MRI

Cerne

Pathrose

Gordon

et al. 2021

Magnetic Resonance Imaging

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Background Cardiac magnetic resonance imaging (MRI) is becoming an alternative to right heart catheterization (RHC) for evaluating pulmonary hypertension (PH). A need exists to further evaluate cardiac MRI's ability to characterize PH. Purpose To evaluate the potential for four‐dimensional (4D) flow MRI‐derived pulmonary artery velocities to characterize PH. Study Type Prospective case–control. Population Fifty‐four PH patients (56% female); 25 controls (36% female). Field Strength/Sequence 1.5 T; gradient recalled echo 4D flow and balanced steady‐state free precession cardiac cine. Assessment RHC was used to derive patients' pulmonary vascular resistance (PVR). 4D flow measured blood velocities at the main, left, and right pulmonary arteries (MPA, LPA, and RPA); cine measured ejection fraction, end diastolic, and end systolic volumes (EF, EDV, and ESV). EDV and ESV were normalized (indexed) to body surface area (ESVI and EDVI). Parameters were evaluated between, and within, PH subgroups: pulmonary arterial hypertension (PAH); PH due to left heart disease (PH‐LHD)/chronic lung disease (PH‐CLD)/or chronic thrombo‐emboli (CTE‐PH). Statistical Tests Analysis of variance and Kruskal–Wallis tests compared parameters between subgroups. Pearson's r assessed velocity, PVR, and volume correlations. Significance definition: P < 0.05. Results PAH peak and mean velocities were significantly lower than in controls at the LPA (36 ± 12 cm/second and 20 ± 4 cm/second vs. 59 ± 15 cm/second and 32 ± 9 cm/second). At the RPA, mean velocities were significantly lower in PAH vs. controls (27 ± 6 cm/second vs. 40 ± 9 cm/second). Peak velocities significantly correlated with right ventricular EF at the MPA (r = 0.286), RPA (r = 0.400), and LPA (r = 0.401). Peak velocity significantly correlated with right ventricular ESVI at the RPA (r = −0.355) and LPA (r = −0.316). Significant correlations between peak velocities and PVR were moderate at the LPA in PAH (r = −0.641) and in PH‐LHD (r = −0.606) patients, and at the MPA in PH‐CLD (r = −0.728). CTE‐PH showed non‐significant correlations between peak velocity and PVR at all locations. Data Conclusion Preliminary findings suggest 4D flow can identify PAH and track PVR changes. Level of Evidence 1 Technical Efficacy Stage 5

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The role of cardiac MRI in the diagnosis and management of sinus venosus atrial septal defect

Cited by 12 publications

References 8 publications

Undiagnosed inferior vena cava type of sinus venosus atrial septal defect in a middle‐aged woman: A rare case report

Undiagnosed inferior vena cava type of sinus venosus atrial septal defect in a middle‐aged woman: A rare case report

Complications caused by iatrogenic right-to-left shunt after surgical closure of atrial septal defect: a case report

Evaluation of Pulmonary Hypertension Using 4D Flow MRI

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