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[Left ventricular reduction surgery: pre- and postoperative evaluation by cine MRI]
D E Kivelitz1, H Hotz, A C Borges
1Institut für Radiologie, Humboldt-Universität, Berlin. dietmar.kivelitz@charite.de
Insights
Cine magnetic resonance imaging (MRI) effectively assesses patients before and after left ventricular (LV) reduction surgery. This cardiac MRI technique reliably shows improved heart function and structure post-operation.
Area of Science:
- Cardiovascular Imaging
- Medical Technology
Background:
- Left ventricular (LV) reduction surgery is a complex procedure for cardiomegaly.
- Accurate preoperative assessment and postoperative monitoring are crucial for patient outcomes.
Purpose of the Study:
- To evaluate the utility of cine magnetic resonance imaging (MRI) in the preoperative assessment of patients undergoing LV reduction surgery.
- To assess the role of cine MRI in the early postoperative follow-up of these patients.
Main Methods:
- Six patients with cardiomegaly underwent cine MRI on a 1.5 T scanner before and after LV reduction surgery.
- Breath-hold, ECG-triggered cine gradient-echo sequences were used for imaging along short and long axes.
- Ventricular and valvular morphology, function (ejection fraction), and volumes (end-diastolic, end-systolic) were assessed.
Main Results:
- Postoperative ejection fraction significantly increased from 21.7% to 33.4% (p < 0.05).
- Left ventricular volumes and myocardial mass significantly decreased post-surgery (p < 0.05).
- Cine MRI reliably identified postoperative valve morphology, mitral valve insufficiency, and ventricular thrombus.
Conclusions:
- Cine MRI is a valuable tool for preoperative evaluation in LV reduction surgery.
- Cine MRI effectively monitors functional and morphological changes in the early postoperative period.
Aim:
To evaluate the role of cine magnetic resonance imaging (MRI) in the preoperative assessment and postoperative follow-up of patients undergoing left ventricular (LV) reduction surgery.
Patients And Methods:
6 patients with cardiomegaly were examined on a 1.5 T MR imager before and after LV reduction surgery. The heart was imaged along the short and long axes using a breath-hold ECG-triggered cine gradient-echo sequence for assessing ventricular and valvular morphology and function and performing volumetry (end-diastolic and end-systolic volumes, ejection fraction).
Results:
Postoperatively, the mean ejection fraction increased from 21.7% to 33.4% and the end-diastolic and end-systolic left ventricular volumes decreased in all patients (304.0 and 252.5 ml before to 205.0 and 141.9 ml after surgery). Mean myocardial mass decreased slightly from 283.8 g to 242.7 g. Differences were significant for all parameters (p < 0.05). MRI allowed for the reliable assessment of post-operative valve morphology and yielded additional findings such as the presence of mitral valve insufficiency or ventricular thrombus.
Conclusions:
Cine MRI provides relevant information prior to left ventricular reduction surgery and reliably depicts functional and morphological changes in the early post-operative follow-up.