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Evaluation of surgical procedures for cyanotic congenital heart disease by using MR imaging
B A Kersting-Sommerhoff1, K C Seelos, C Hardy
1Department of Radiology, University of California, San Francisco 94143.
Insights
Electrocardiogram-gated magnetic resonance (MR) imaging effectively evaluates complex congenital heart disease after surgery. This non-invasive technique offers an alternative to angiography for postoperative assessment in children.
Area of Science:
- Cardiovascular Imaging
- Pediatric Cardiology
- Medical Diagnostics
Background:
- Electrocardiogram-gated MR imaging is established for diagnosing congenital heart disease.
- Postoperative evaluation of complex congenital heart disease requires accurate imaging modalities.
Purpose of the Study:
- To assess the utility of ECG-gated MR imaging in the postoperative evaluation of complex congenital heart disease.
- To compare the diagnostic accuracy of MR imaging with angiography in these patients.
Main Methods:
- Retrospective analysis of MR images from 26 patients who underwent various surgical procedures for congenital heart disease.
- Comparison of MR imaging findings with angiography in 20 of these patients.
- Evaluation of surgical anastomoses, pulmonary artery status, and specific postoperative complications.
Main Results:
- Surgical anastomoses were successfully identified in all patients via MR imaging.
- MR imaging accurately depicted pulmonary artery patency, atresia, hypoplasia, and complications like stenoses, thrombosed conduits, and abscesses.
- Specific Jatene procedure complications, including right ventricular outflow tract narrowing and proximal pulmonary artery compression, were identified.
Conclusions:
- ECG-gated MR imaging is effective for the postoperative evaluation of surgical procedures in complex congenital heart disease.
- MR imaging serves as a valuable alternative to repeated catheterization and angiography for pediatric patients.
- This modality aids in identifying surgical success and detecting postoperative complications.
Abstract:
ECG-gated MR imaging has been shown to be effective for the diagnosis of congenital heart disease. In this study, we assessed its role in the postoperative evaluation of surgical procedures in patients with complex congenital heart disease. MR images of 26 patients with Rastelli (five), Fontan (three), Senning (three), Damus (one), Jatene (eight), Waterston (four), and Potts (two) procedures were evaluated retrospectively. The accuracy of MR imaging was compared with that of angiography in 20 patients. The surgical anastomoses were identified in all patients. Patency, atresia, or hypoplasia of central pulmonary arteries and postoperative complications (focal stenoses of pulmonary arteries, thrombosed conduit, peri-conduit abscess) were shown. Narrowing of the right ventricular outflow tract and focal compression of the proximal pulmonary arteries were recognized as specific complications of the Jatene procedure. MR imaging appears to be effective in the postoperative evaluation of surgical procedures used for congenital heart disease. It should be considered as an alternative to repeated catheterization and angiography for the postoperative examination of children with complex congenital heart disease.