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Updated: Sep 4, 2025
Surgery and Sample Processing for Correlative Imaging of the Murine Pulmonary Valve
Published on: August 5, 2021
Noninvasive imaging prior to percutaneous pulmonary valve implantation
Maria Boutsikou1, Aphrodite Tzifa2
1Cardiac MRI Dpt, Mediterraneo Hospital, Ilias 8-12, Glyfada, 16674, Athens, Greece.
Insights
Congenital heart disease patients needing interventions often involve the right ventricular outflow tract. Advanced imaging like CT and MRI is crucial for planning percutaneous pulmonary valve replacement, ensuring patient safety and procedural success.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Cardiology
Background:
- Many adults with congenital heart disease (CHD) require further interventions after childhood open-heart surgery.
- Right ventricular outflow tract (RVOT) issues are common, often necessitating pulmonary valve replacement.
- Percutaneous pulmonary valve replacement (PPVR) offers a less invasive alternative to surgical pulmonary valve replacement (SPVR).
Purpose of the Study:
- To highlight the importance of pre-interventional imaging in patients undergoing percutaneous pulmonary valve replacement (PPVR).
- To discuss how imaging influences the selection of suitable candidates and reduces complication risks.
- To review various imaging modalities used for pre-procedural planning in RVOT interventions.
Main Methods:
- Review of established and newer imaging techniques for pre-procedural assessment in PPVR.
- Discussion of 2D and 3D fluoroscopy, cardiovascular magnetic resonance (CMR), computed tomography (CT), and fusion imaging.
- Emphasis on the role of imaging in evaluating RVOT anatomy, coronary artery course, and pulmonary artery branching.
Main Results:
- Variability in RVOT anatomy, coronary artery proximity, and pulmonary artery anatomy are key factors for intervention success.
- Pre-interventional imaging is essential for selecting appropriate candidates for PPVR.
- CMR, CT, and fusion imaging are efficient and reliable tools for pre-procedural planning.
Conclusions:
- Accurate pre-procedural imaging is critical for successful and safe percutaneous pulmonary valve replacement.
- Advanced imaging techniques improve patient selection and minimize risks associated with RVOT interventions.
- Comprehensive imaging assessment ensures optimal outcomes for patients with congenital heart disease requiring PPVR.
Abstract:
The majority of patients with congenital heart disease (CHD) who have undergone open heart surgery during childhood are possible candidates for additional transcatheter or surgical interventions. One fifth of these conditions usually involve the right ventricular outflow tract (RVOT). Percutaneous pulmonary valve replacement (PPVR) has been widely established as an alternative, less invasive option to surgical pulmonary valve replacement (SPVR). The variability of RVOT anatomy and size, the relative course of the coronary arteries, and the anatomy of the pulmonary artery branches are factors that determine the success of the intervention and the complication rates. Careful and reliable pre-interventional imaging warrants the selection of suitable candidates and minimizes the risk of complications. 2D and 3D fluoroscopy have been extensively used during pre- and peri-interventional assessment. Established imaging techniques such as cardiovascular magnetic resonance (CMR) and computed tomography (CT) and newer techniques such as fusion imaging have proved to be efficient and reliable tools during pre-procedural planning in patients assessed for PPVR.
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