Variation in Advanced Diagnostic Imaging Practice Patterns and Associated Risks Prior to Superior Cavopulmonary...

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• Single ventricle patients require advanced diagnostic imaging before superior cavopulmonary connection (SCPC) surgery.
• Current diagnostic practices and associated risks show significant variability.

Purpose of the Study:

• To evaluate the variability in advanced diagnostic imaging modalities used before SCPC.
• To compare the comprehensive risks associated with different imaging techniques.

Main Methods:

• Retrospective analysis of 617 patients undergoing SCPC across 4 institutions (2010-2016).
• Comparison of cardiac catheterization (CC), cardiac magnetic resonance (CMR), and cardiac computed tomography (CT) as primary imaging modalities.
• Assessment of risks including anesthesia, vascular access, room time, contrast, radiation, and adverse events.

Main Results:

• Of 409 patients with pre-SCPC imaging, diagnostic CC was most common (59%), followed by CT (27%) and CMR (14%).
• Imaging modality choice varied significantly by institution (p < 0.001).
• Cardiac catheterization involved higher radiation doses and adverse event rates (12%) compared to CT (1%) and CMR (6%).

Conclusions:

• Significant practice variability exists in pre-SCPC advanced diagnostic imaging.
• Differences in procedural risks, particularly radiation and adverse events, are associated with imaging modality choice.
• Further research is needed to optimize diagnostic protocols based on accuracy and long-term outcomes.