scholarly journals Wall shear stress in the thoracic aorta at rest and with dobutamine stress after arterial switch operation

2020 ◽  
Author(s):  
Roel L F van der Palen ◽  
Joe F Juffermans ◽  
Lucia J M Kroft ◽  
Mark G Hazekamp ◽  
Hildo J Lamb ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Thoracic Aorta ◽  
Aortic Wall ◽  
Arterial Switch Operation ◽  
Dobutamine Stress ◽  
Lv Function ◽  
Resonance Imaging ◽  
4D Flow ◽  
Switch Operation ◽  
Lv Ejection Fraction

Abstract OBJECTIVES Progressive root dilatation is an important complication in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) that may be caused by altered flow dynamics. Aortic wall shear stress (WSS) distribution at rest and under dobutamine stress (DS) conditions using 4D flow magnetic resonance imaging were investigated in relation to thoracic aorta geometry. METHODS 4D flow magnetic resonance imaging was performed in 16 adolescent TGA patients after ASO (rest and DS condition) and in 10 healthy controls (rest). The primary outcome measure was the WSS distribution along the aortic segments and the WSS change with DS in TGA patients. Based on the results, we secondary zoomed in on factors [aortic geometry and left ventricular (LV) function parameters] that might relate to these WSS distribution differences. Aortic diameters, arch angle, LV function parameters (stroke volume, LV ejection fraction, cardiac output) and peak systolic aortic WSS were obtained. RESULTS TGA patients had significantly larger neoaortic root and smaller mid-ascending aorta (AAo) dimensions and aortic arch angle. At rest, patients had significantly higher WSS in the entire thoracic aorta, except for the dilated root. High WSS levels beyond the proximal AAo were associated with the diameter decrease from the root to the mid-AAo (correlation coefficient r = 0.54–0.59, P = 0.022–0.031), not associated with the aortic arch angle. During DS, WSS increased in all aortic segments (P < 0.001), most pronounced in the AAo segments. The increase in LV ejection fraction, stroke volume and cardiac output as a result of DS showed a moderate linear relationship with the WSS increase in the distal AAo (correlation coefficient r = 0.54–0.57, P = 0.002–0.038). CONCLUSIONS Increased aortic WSS was observed in TGA patients after ASO, related to the ASO-specific geometry, which increased with DS. Stress-enhanced elevated WSS may play a role in neoaortic root dilatation and anterior aortic wall thinning of the distal AAo.

scholarly journals Right and left ventricular function and flow quantification in pediatric patients with repaired tetralogy of Fallot using four-dimensional flow magnetic resonance imaging

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofen Yao ◽  
Liwei Hu ◽  
Yafeng Peng ◽  
Fei Feng ◽  
Rongzhen Ouyang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Left Ventricular ◽  
Flow Quantification ◽  
Lv Function ◽  
Resonance Imaging ◽  
4D Flow ◽  
Ssfp Cine ◽  
Flow Measurements

Abstract Background To assess the accuracy and reproducibility of right ventricular (RV) and left ventricular (LV) function and flow measurements in children with repaired tetralogy of Fallot (rTOF) using four-dimensional (4D) flow, compared with conventional two-dimensional (2D) magnetic resonance imaging (MRI) sequences. Methods Thirty pediatric patients with rTOF were retrospectively enrolled to undergo 2D balanced steady-state free precession cine (2D b-SSFP cine), 2D phase contrast (PC), and 4D flow cardiac MRI. LV and RV volumes and flow in the ascending aorta (AAO) and main pulmonary artery (MPA) were quantified. Pearson’s or Spearman’s correlation tests, paired t-tests, the Wilcoxon signed-rank test, Bland–Altman analysis, and intraclass correlation coefficients (ICC) were performed. Results The 4D flow scan time was shorter compared with 2D sequences (P < 0.001). The biventricular volumes between 4D flow and 2D b-SSFP cine had no significant differences (P > 0.05), and showed strong correlations (r > 0.90, P < 0.001) and good consistency. The flow measurements of the AAO and MPA between 4D flow and 2D PC showed moderate to good correlations (r > 0.60, P < 0.001). There was good internal consistency in cardiac output. There was good intraobserver and interobserver biventricular function agreement (ICC > 0.85). Conclusions RV and LV function and flow quantification in pediatric patients with rTOF using 4D flow MRI can be measured accurately and reproducibly compared to those with conventional 2D sequences.

Post-operative Assessment of the Arterial Switch Operation: A Comparison of Magnetic Resonance Imaging and Echocardiography

2018 ◽  
Vol 39 (5) ◽  
pp. 1036-1041 ◽  
Author(s):  
Christopher R. Broda ◽  
Svetlana B. Shugh ◽  
Rohan B. Parikh ◽  
YunFei Wang ◽  
Tobias R. Schlingmann ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Arterial Switch Operation ◽  
Resonance Imaging ◽  
Arterial Switch ◽  
Switch Operation ◽  
Operative Assessment

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 Capabilities of cardiac magnetic resonance imaging and magnetic resonance angiography of the great vessels in children with transposition of the great vessels

2021 ◽  
Vol 36 (2) ◽  
pp. 115-122
Author(s):  
A. A. Malov ◽  
Y. B. Kalinicheva ◽  
D. I. Sadykova ◽  
O. V. Krasnoperova ◽  
D. Yu. Petrushenko ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Coronary Angiography ◽  
Mr Angiography ◽  
Arterial Switch Operation ◽  
Heart Catheterization ◽  
Resonance Imaging ◽  
Dynamic Observation ◽  
Switch Operation ◽  
Great Vessels

Aim. To demonstrate the capabilities of magnetic resonance imaging (MRI) and magnetic resonance (MR) angiography in the complex examination of patients with various types of transposition of great arteries (TGA) at the pre- and postoperative stages.Material and Methods. A total of 38 MRI studies of the heart and blood vessels were performed in 33 patients with various forms of transposition of great vessels.Results. The main purpose of MRI was to identify postoperative complications after arterial switch operation for simple TGA. Cicatricial changes in the wall of the left ventricle were revealed in two patients, which was the basis for coronary angiography. Coronary angiography revealed no significant coronary artery stenosis requiring surgical intervention. The aortic root was dilated to an average of + 2.85 Z-score in six patients after arterial switch operation, which required further dynamic observation. Stenosis of the branches of the pulmonary artery due to the use of the Lecompte maneuver was revealed in one patient. Heart catheterization was performed according to the results of MRI. Invasive pressure measurement revealed neither significant stenosis nor indications for surgical treatment. MRI data were used as one of the criteria for anatomical correction readiness in group of patients with congenitally corrected transposition of the great vessels, along with data of echocardiography and heart catheterization.Conclusion. MRI and MR angiography are the “gold standard” in the pre- and postoperative examination of patients with various forms of TGA . Using MR angiography, it is possible to carry out morphometry and clarify the spatial arrangement of vessels including that after correction of TGA. In most cases, MRI allows to correctly differentiate the morphology of the heart chambers and their relative position. It also allows to perform volumetry and to assess the parameters of local and global contractile function of the ventricles, which is essential for preoperative assessment and dynamic observation at all stages of correction.

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