Dataset Information

X-ray fused with MRI guidance of pre-selected transcatheter congenital heart disease interventions.

ABSTRACT: OBJECTIVES:To determine whether X-ray fused with MRI (XFM) is beneficial for select transcatheter congenital heart disease interventions. BACKGROUND:Complex transcatheter interventions often require three-dimensional (3D) soft tissue imaging guidance. Fusion imaging with live X-ray fluoroscopy can potentially improve and simplify procedures. METHODS:Patients referred for select congenital heart disease interventions were prospectively enrolled. Cardiac MRI data was overlaid on live fluoroscopy for procedural guidance. Likert scale operator assessments of value were recorded. Fluoroscopy time, radiation exposure, contrast dose, and procedure time were compared to matched cases from our institutional experience. RESULTS:Forty-six patients were enrolled. Pre-catheterization, same day cardiac MRI findings indicated intervention should be deferred in nine patients. XFM-guided cardiac catheterization was performed in 37 (median age 8.7 years [0.5-63?years]; median weight 28?kg [5.6-110?kg]) with the following prespecified indications: pulmonary artery (PA) stenosis (n =?13), aortic coarctation (n =?12), conduit stenosis/insufficiency (n = 9), and ventricular septal defect (n = 3). Diagnostic catheterization showed intervention was not indicated in 12 additional cases. XFM-guided intervention was performed in the remaining 25. Fluoroscopy time was shorter for XFM-guided intervention cases compared to matched controls. There was no significant difference in radiation dose area product, contrast volume, or procedure time. Operator Likert scores indicated XFM provided useful soft tissue guidance in all cases and was never misleading. CONCLUSIONS:XFM provides operators with meaningful three-dimensional soft tissue data and reduces fluoroscopy time in select congenital heart disease interventions.

SUBMITTER: Grant EK

PROVIDER: S-EPMC6823111 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

X-ray fused with MRI guidance of pre-selected transcatheter congenital heart disease interventions.

Grant Elena K EK Kanter Joshua P JP Olivieri Laura J LJ Cross Russell R RR Campbell-Washburn Adrienne A Faranesh Anthony Z AZ Cronin Ileen I Hamann Karin S KS O'Byrne Michael L ML Slack Michael C MC Lederman Robert J RJ Ratnayaka Kanishka K

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 20190506 3

<h4>Objectives</h4>To determine whether X-ray fused with MRI (XFM) is beneficial for select transcatheter congenital heart disease interventions.<h4>Background</h4>Complex transcatheter interventions often require three-dimensional (3D) soft tissue imaging guidance. Fusion imaging with live X-ray fluoroscopy can potentially improve and simplify procedures.<h4>Methods</h4>Patients referred for select congenital heart disease interventions were prospectively enrolled. Cardiac MRI data was overlaid ...[more]

PMID: 31062506

Similar Datasets

Project description:IntroductionA substantial proportion of patients with adult congenital heart disease (ACHD) suffer from worsening valvular dysfunction in adulthood. Transcatheter valve interventions can offer a therapeutic alternative to surgery for those at high surgical risk. There is emerging but limited data on transcatheter interventions for atrioventricular (AV) valve dysfunction in patients with ACHD.MethodsWe compiled an international collaborative multi-center registry focusing on adult patients with congenital heart disease undergoing transcatheter AV valve interventions (repair or replacement). Included were patients from three international centers who underwent procedures between 2016 and 2022. Demographic, clinical, and procedural data were compiled.ResultsNine patients with ACHD underwent AV valve interventions. The median age was 48 years (IQR (37; 56), 55% women). At baseline, seven patients (78%) were in NYHA functional class III and two (22%) were in NYHA functional class II. The diagnosis of ACHD varied. Three valve interventions were performed on the subpulmonary AV valve and six on the systemic AV valve. The primary valvular pathology was regurgitation (six patients, 78%). Five procedures were valve-in-valve interventions, and four procedures were transcatheter edge-to-edge repair procedures. There were no major complications or peri-procedural complications or peri-procedural mortality. One patient developed a suspected non-obstructive thrombus on the valve that was medically treated. One patient did not improve clinically following the procedure and underwent a heart transplant, one patient died 6 months following the procedure due to a cardiovascular implantable electronic device infection. At one year, six patients were in NYHA functional class I, and one patient was in NYHA functional class III. In conclusion, transcatheter AV heart valve interventions are feasible and safe procedures in carefully selected ACHD patients. These procedures can offer an effective treatment option in these younger patients with high surgical risk.

Dataset Information

X-ray fused with MRI guidance of pre-selected transcatheter congenital heart disease interventions.

Publications

X-ray fused with MRI guidance of pre-selected transcatheter congenital heart disease interventions.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets