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.

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

scholarly journals Neoaortic Regurgitation in Patients with Transposition Long Term After an Arterial Switch Operation and Its Relation to the Root Diameters and Surgical Technique Used

2019 ◽  
Vol 41 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Krzysztof W. Michalak ◽  
Katarzyna Sobczak-Budlewska ◽  
Jacek J. Moll ◽  
Konrad Szymczyk ◽  
Jadwiga A. Moll ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Technique ◽  
Transthoracic Echocardiography ◽  
Multimodality Imaging ◽  
Arterial Switch Operation ◽  
Resonance Imaging ◽  
Arterial Switch ◽  
Switch Operation

Abstract Neoaortic regurgitation and root dilatation are common findings in patients with transposition after an arterial switch operation. The aim of this study was to describe the relation between neoaortic regurgitation long term after an arterial switch procedure, aortic root diameters, and surgical technique used. We also assessed the agreement of the neoaortic regurgitation grade and root diameters in different imaging modalities. For this retrospective study, we qualified 56 consecutive patients who, according to our institutional protocol, had a routine postoperative evaluation of more than 16 years with multimodality imaging studies. Neoaortic regurgitation was assessed by both transthoracic echocardiography and magnetic resonance imaging, and the root diameters obtained by echocardiography and tomography were compared to the reference values and associated with the presence of neoaortic insufficiency. Neoaortic insufficiency was present in 75% of examined patients; the vast majority of them had trace or mild regurgitation, and its qualitative evaluation was significantly different between echocardiography and magnetic resonance imaging. In our study group, the neoaortic valve and aortic sinus were larger in relation to the normal values, and they were significantly correlated with the presence of neoaortic insufficiency, but not with the surgical technique used. Values obtained by echocardiography and tomography correlated well but were significantly different. Transthoracic echocardiography has a tendency to overestimate the severity of regurgitation compared to magnetic resonance imaging. Neoaortic valve and sinus dilatation are significantly correlated with valve insufficiency, but in most cases of root dilatation, the valve remains competent.

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.

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