Cardiac magnetic resonance imaging characterizes stenosis, perfusion, and fibrosis preoperatively and postoperatively in children with anomalous coronary arteries
| Autor: | Julie A. Brothers, Timothy S. Kim, Mark A. Fogel, Kevin K. Whitehead, Tonia M. Morrison, Stephen M. Paridon, Matthew A. Harris |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Coronary Vessel Anomalies Magnetic Resonance Imaging Cine Angioscopy 030204 cardiovascular system & hematology Ventricular Function Left Sudden cardiac death Young Adult 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Internal medicine medicine.artery Humans Medicine Prospective Studies Cardiac Surgical Procedures Child Aorta medicine.diagnostic_test business.industry Reproducibility of Results Prognosis medicine.disease Coronary Vessels Fibrosis Coronary arteries Ostium medicine.anatomical_structure 030228 respiratory system Child Preschool Anomalous aortic origin of a coronary artery Cardiology Female Surgery Radiology Cardiology and Cardiovascular Medicine business Follow-Up Studies Artery |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 152:205-210 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2015.12.057 |
| Popis: | Using cardiac magnetic resonance imaging (MRI) with virtual angioscopy, we sought to evaluate coronary anatomy, myocardial injury, and left ventricular function in children with interarterial anomalous aortic origin of coronary artery before and after surgery.We prospectively enrolled children 5 to 19 years old with interarterial anomalous coronary artery. Cardiac MRI was performed with respiratory-navigated steady-state free-precession 3-dimensional data set acquisition. Virtual angioscopy was used to evaluate the coronary ostia directly. Surgery consisted of the modified unroofing procedure.We enrolled 9 subjects between February 2009 and May 2015. Subjects were male, with an average age at surgery of 14.1 years. Anomalous coronary was right in 7 patients (77%) and left in 2. In all subjects, the proximal anomalous coronary arose tangential to the aorta with an elliptical, slitlike ostium. Before the operation, the proximal coronary artery was significantly smaller proximally than distally (2 vs 3.1 mm; P .0001. After the operation, neo-orifices were round and patent in 7 subjects; however, 2 subjects still had narrowed neo-orifices. New postoperative MRI findings included flattened septal wall motion (N = 1), small region of midmyocardial partial-thickness scar (N = 1), and dyskinetic septal wall motion with mild aortic insufficiency (N = 1). Left ventricular function was normal both before and after surgery (P = .85).Cardiac MRI with virtual angioscopy is an important tool for evaluating anomalous coronary anatomy, myocardial function, and ischemia and should be considered for initial and postoperative assessment of children with anomalous coronary arteries. |
| Databáze: | OpenAIRE |
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