scholarly journals 3D Heart Model and 4D Flow MRI 20 Years after Spiral Arterial Switch Operation

2016 ◽  
Vol 05 (01) ◽  
pp. 44-46 ◽  
Author(s):  
Arash Kheradvar ◽  
Hans-Heiner Kramer ◽  
Carsten Rickers ◽  
Hans-Hinrich Sievers
Keyword(s):  
Arterial Switch Operation ◽  
Heart Model ◽  
4D Flow Mri ◽  
4D Flow ◽  
Arterial Switch ◽  
Switch Operation ◽  
Flow Mri

Neopulmonary Outflow Tract Obstruction Assessment by 4D Flow MRI in Adults With Transposition of the Great Arteries After Arterial Switch Operation

2019 ◽  
Vol 51 (6) ◽  
pp. 1699-1705 ◽  
Author(s):  
Zahra Belhadjer ◽  
Gilles Soulat ◽  
Magalie Ladouceur ◽  
Francesca Pitocco ◽  
Antoine Legendre ◽  
...  
Keyword(s):  
Arterial Switch Operation ◽  
Outflow Tract ◽  
4D Flow Mri ◽  
4D Flow ◽  
Arterial Switch ◽  
Switch Operation ◽  
Flow Mri

Abstract 16422: 4D Flow MRI Improves Assessment of Aortic and Pulmonary Peak Velocities in Patients With D-Transposition of Great Arteries Following Arterial Switch Operation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kelly Jarvis ◽  
Susanne Schnell ◽  
Alex Barker ◽  
Marleen Vonder ◽  
Michael Rose ◽  
...  
Keyword(s):  
Peak Velocity ◽  
Arterial Switch Operation ◽  
Pulmonary Arteries ◽  
Velocity Measurements ◽  
4D Flow Mri ◽  
4D Flow ◽  
Arterial Switch ◽  
Switch Operation ◽  
Significant Difference ◽  
Flow Mri

BACKGROUND: Pulmonary artery stenosis is the most common complication seen following the arterial switch operation (ASO) for D-transposition of the great arteries (DTGA). During follow-up, it is important to accurately detect peak velocity as an indicator of vessel narrowing. The purpose of this study was to compare peak velocity measurements by 4D flow MRI (4D flow) (with full volumetric coverage of aorta and pulmonary system) to those by standard 2D phase contrast MRI (2D PC) and Doppler echo. METHODS: 4D flow and 2D PC were performed in n=14 subjects (age = 12.4 ± 7.6, range = 1 to 25) with DTGA s/p ASO. 3D segmentation of the aorta (Ao) and pulmonary arteries (PAs) was performed to isolate 4D flow velocities for these vessels (Figure a). The location and value of peak systolic velocity was determined inside volumes of interest for the ascending aorta (AAO), main (MPA), right (RPA) and left pulmonary arteries (LPA). RPA and LPA 2D PC data were not available in one patient. Contemporary echo data were available in 11 patients (11 AAO, 8 MPA, 6 RPA, 5 LPA). RESULTS: Peak velocity measurements by 4D flow were significantly higher than 2D PC in all regions (AAO: 1.51±0.61m/s vs. 1.15±0.24m/s, p = 0.016; MPA: 2.08±1.11m/s vs. 1.44± 0.61m/s, p = 0.004; RPA: 2.19±0.65m/s vs. 1.79±0.81m/s, p = 0.027; LPA: 2.08±0.85m/s vs. 1.74±0.70m/s, p = 0.014). Regression results indicated strong relationships between 4D flow and 2D PC (AAO: R2 = 0.46, p = 0.008; MPA: R2 = 0.69, p = 0.0002; RPA: R2 =0.50, p = 0.007; LPA: R2 = 0.74, p = 0.0001) (Figure b). No significant difference was found between peak velocities measured by 4D flow and echo (AAO: p = 0.32, MPA: p = 0.24, RPA: p = 0.91, LPA: p = 0.36) or by 2D PC and echo (AAO: p = 0.49, MPA: p = 0.62, RPA: p = 0.35, LPA: p = 0.066). CONCLUSION: 4D flow outperformed 2D PC for detecting peak velocity in the Ao and PAs. No significant difference was found between peak velocities measured by 4D flow and echo. Further studies are warranted in a larger patient cohort to determine clinical impact.

A Quarter-Century After Primary Direct Arterial Switch Operation: Four-D-Flow MRI Video Imaging of Blood Flow Dynamics Outcomes

2017 ◽  
Vol 8 (5) ◽  
pp. 637-638
Author(s):  
Hans-Hinrich Sievers ◽  
Dominik Gabbert ◽  
Carsten Rickers
Keyword(s):  
Magnetic Resonance Imaging ◽  
Arterial Switch Operation ◽  
Flow Dynamics ◽  
Resonance Imaging ◽  
Quarter Century ◽  
Arterial Switch ◽  
Switch Operation ◽  
Blood Flow Dynamics ◽  
Flow Mri ◽  
Magnetic Resonance Imaging Mri

Four-dimensional (4-D) flow magnetic resonance imaging (MRI) examination was performed 25 years after a neonatal direct arterial switch operation for simple transposition of the great arteries. The 4-D flow MRI video shows physiological spiral anatomical configuration and laminar streamlines in the great arteries.

scholarly journals Assessment of ventricular flow dynamics by 4D-flow MRI in patients following surgical repair of d-transposition of the great arteries

2021 ◽  
Author(s):  
Fraser M. Callaghan ◽  
Barbara Burkhardt ◽  
Emanuela R. Valsangiacomo Buechel ◽  
Christian J. Kellenberger ◽  
Julia Geiger
Keyword(s):  
Normal Subjects ◽  
Flow Dynamics ◽  
4D Flow Mri ◽  
4D Flow ◽  
Direct Flow ◽  
Arterial Switch ◽  
Atrial Switch ◽  
Intraventricular Flow ◽  
Flow Mri ◽  
Flow Components

Abstract Objectives To use 4D-flow MRI to describe systemic and non-systemic ventricular flow organisation and energy loss in patients with repaired d-transposition of the great arteries (d-TGA) and normal subjects. Methods Pathline tracking of ventricular volumes was performed using 4D-flow MRI data from a 1.5-T GE Discovery MR450 scanner. D-TGA patients following arterial switch (n = 17, mean age 14 ± 5 years) and atrial switch (n = 15, 35 ± 6 years) procedures were examined and compared with subjects with normal cardiac anatomy and ventricular function (n = 12, 12 ± 3 years). Pathlines were classified by their passage through the ventricles as direct flow, retained inflow, delayed ejection flow, and residual volume and visually and quantitatively assessed. Additionally, viscous energy losses (ELv) were calculated. Results In normal subjects, the ventricular flow paths were well ordered following similar trajectories through the ventricles with very little mixing of flow components. The flow paths in all atrial and some arterial switch patients were more irregular with high mixing. Direct flow and delayed ejection flow were decreased in atrial switch patients’ systemic ventricles with a corresponding increase in residual volume compared with normal subjects (p = 0.003 and p < 0.001 respectively) and arterial switch patients (p < 0.0001 and p < 0.001 respectively). In non-systemic ventricles, arterial switch patients had increased direct flow and decreased delayed ejection fractions compared to normal (p = 0.007 and p < 0.001 respectively) and atrial switch patients (p = 0.01 and p < 0.001 respectively). Regions of high levels of mixing of ventricular flow components showed elevated ELv. Conclusions 4D-flow MRI pathline tracking reveals disordered ventricular flow patterns and associated ELv in d-TGA patients. Key Points • 4D-flow MRI can be used to assess intraventricular flow dynamics in d-TGA patients. • d-TGA arterial switch patients mostly show intraventricular flow dynamics representative of normal subjects, while atrial switch patients show increased flow disorder and different proportions of intraventricular flow volumes. • Flow disruption and disorder increase viscous energy losses.

scholarly journals 4D flow streamline characteristics of the great arteries twenty years after Lecompte and direct spiral arterial switch operation (DSASO) in simple TGA

2016 ◽  
Vol 2016 (3) ◽  
Author(s):  
Hans-Hinrich Sievers ◽  
Léon M Putman ◽  
Arash Kheradvar ◽  
Dominik Gabbert ◽  
Philip Wegner ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Arterial Switch Operation ◽  
Surgical Techniques ◽  
4D Flow ◽  
Arterial Switch ◽  
Semilunar Valves ◽  
Early Results ◽  
Switch Operation ◽  
Potential Problems ◽  
Flow Study

Transposition of the great arteries (TGA) is caused by discordance between the great arteries andthe ventricles. If left untreated, this anomaly has a disastrous perspective. More recent surgical approach for correction includes the Lecompte technique in which the pulmonary bifurcation is transposed anterior to the aorta, which may be less physiologic. Although the early results are excellent, there is potential for future problems involving the great arteries and semilunar valves. These potential problems necessitate the development of other improved surgical techniques . Here we report an MRI 4D flow study related to a case of simple TGA whose primary surgical correction – direct spiral arterial switch operation (DSASO) – was performed twenty years ago in an attempt to restore physiologic arrangement among the great arteries and semilunar valves. 

4D-Flow MRI: Beyond the Images

2020 ◽  
Vol 32 (1) ◽  
pp. 35
Author(s):  
Pietro Sergio ◽  
Antonio Miceli
Keyword(s):  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri
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