Document Detail


3-dimensional time-resolved contrast-enhanced magnetic resonance angiography for evaluation late after the mustard operation for transposition.
MedLine Citation:
PMID:  19930771     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Cardiovascular magnetic resonance assessment of adults late after an atrial redirection operation for transposition is demanding and time consuming. We hypothesised that the relatively fast and standardised 3-dimensional time-resolved contrast-enhanced magnetic resonance angiography, or dynamic angiography, would be valuable in the periodic follow-up of these patients. METHODS: We investigated prospectively 36 adults with transposition using dynamic angiography, comparing our results against a comprehensive but non-contrast cardiovascular magnetic resonance protocol. We acquired 6 dynamic angiographic datasets after injection of contrast. The primary aim was to detect significant obstruction of the pathways for venous flow. RESULTS: In 4 patients (11%), we found evidence of moderate-to-severe, and thus clinically important, obstruction of systemic venous channels on standard cardiovascular magnetic resonance. All these patients were correctly identified by dynamic angiography. In 4 additional patients, we found mild and haemodynamically insignificant obstructions in the systemic venous channels. Of the 8 (22%) patients with any obstruction, 6 were detected by angiography. There were no false positives reported, giving sensitivity of 75% and specificity of 100%, a positive predictive value of 100%, and negative predictive value of 93%. In 1 patient, there was a moderate obstruction of the pulmonary venous compartment which was not readily seen by dynamic angiography. CONCLUSIONS: 3-dimensional dynamic angiography is a useful method for detecting anatomically moderate-to-severe, but not mild, obstructions in the systemic venous channels following Mustard repair for transposition. This technique can be used as a single imaging method and/or as complimentary to standard two dimensional cardiovascular magnetic resonance techniques for detection of clinically important obstructions in the systemic venous channels.
Authors:
Bengt Johansson; Sonya V Babu-Narayan; Philip J Kilner; Timothy M Cannell; Raad H Mohiaddin
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-24
Journal Detail:
Title:  Cardiology in the young     Volume:  20     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Affiliation:
Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, SW3 6NP, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Surgical Procedures / adverse effects*,  methods
Cohort Studies
Constriction, Pathologic / diagnosis
Contrast Media / diagnostic use
Female
Follow-Up Studies
Humans
Image Enhancement / methods*
Imaging, Three-Dimensional / methods*
Magnetic Resonance Angiography / methods*
Postoperative Complications / diagnosis
Predictive Value of Tests
Pulmonary Veins
Sensitivity and Specificity
Transposition of Great Vessels / diagnosis,  surgery*
Vena Cava, Superior
Venous Thrombosis / diagnosis*,  etiology
Young Adult
Grant Support
ID/Acronym/Agency:
//British Heart Foundation
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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