HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gutberlet, M. Articles by Felix, R. Search for Related Content PubMed PubMed Citation Articles by Gutberlet, M. Articles by Felix, R.

Arterial Switch Procedure for D-Transposition of the Great Arteries: Quantitative Midterm Evaluation of Hemodynamic Changes with Cine MR Imaging and Phase-Shift Velocity Mapping-Initial Experience¹

¹ From the Departments of Radiology (M.G., N.H., T.K., H.O., T.E., S.V., R.F.) and Pediatric Cardiology (T.B., G.B.), Charité, Campus Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität, Augustenburger Platz 1, 13353 Berlin, Germany, and the Departments of Congenital Heart Disease and Pediatric Cardiology (M.V.) and Cardiac, Thoracic, and Vascular Surgery (R.H.), German Heart Institute, Berlin. From the 1998 RSNA scientific assembly. Received December 17, 1998; revision requested February 8, 1999; revision received May 4; accepted August 20. Address reprint requests to M.G. (e-mail: matthias.gutberlet@charite.de).

PURPOSE: To evaluate cine magnetic resonance (MR) imaging and phase-shift velocity mapping for assessment of the hemodynamic relevance of stenotic segments or specific hemodynamic changes in the great vessels after an arterial switch procedure for correction of D-transposition of the great arteries.

MATERIALS AND METHODS: Twenty consecutive patients (age range, 2–17 years) with an acoustic window that was insufficient for Doppler transthoracic echocardiography were included in the study. Flow and diameter measurements of the pulmonary arterial trunk and its primary branches were performed with phase-shift velocity mapping and cine MR imaging.

RESULTS: There were good correlations between pressure gradients in the pulmonary arteries estimated with MR imaging and those measured with Doppler echocardiography (r = 0.83, n = 15) and cardiac catheterization (r = 0.90, n = 13). Cine MR imaging revealed that the diameters of the right and left pulmonary arteries decreased with the expansion of the aorta during systole, which increased the peak velocity. This temporary stenosis was more severe in the right than in the left pulmonary artery and was accompanied by a significantly (P < .05) lower volume flow in the right artery.

CONCLUSION: The anatomic situation after arterial switch repair tended to produce temporary stenoses in the primary pulmonary arterial branches, with significant changes in hemodynamics. These changes may affect the long-term outcome and go undetected with other imaging modalities.

Index terms: Aorta, flow dynamics • Aorta, MR, 564.12142, 941.129411, 941.129412 • Aorta, surgery, 56.459, 941.459 • Pulmonary arteries, flow dynamics • Pulmonary arteries, MR, 564.121411, 564.121412, 564.12144 • Transposition of great vessels, 564.1612, 941.149

This article has been cited by other articles:

				H. B. Grotenhuis, A. de Roos, J. Ottenkamp, P. H. Schoof, H. W. Vliegen, and L. J. M. Kroft MR Imaging of Right Ventricular Function after the Ross Procedure for Aortic Valve Replacement: Initial Experience Radiology, December 4, 2007; (2007) 2462070198. [Abstract] [Full Text]

				E. Rodriguez, R. Soler, R. Fernandez, and I. Raposo Postoperative Imaging in Cyanotic Congenital Heart Diseases: Part 1, Normal Findings Am. J. Roentgenol., December 1, 2007; 189(6): 1353 - 1360. [Abstract] [Full Text] [PDF]

				R. Soler, E. Rodriguez, M. Alvarez, and I. Raposo Postoperative Imaging in Cyanotic Congenital Heart Diseases: Part 2, Complications Am. J. Roentgenol., December 1, 2007; 189(6): 1361 - 1369. [Abstract] [Full Text] [PDF]

				H B Grotenhuis, L J M Kroft, S G C van Elderen, J J M Westenberg, J Doornbos, M G Hazekamp, H W Vliegen, J Ottenkamp, and A de Roos Right ventricular hypertrophy and diastolic dysfunction in arterial switch patients without pulmonary artery stenosis Heart, December 1, 2007; 93(12): 1604 - 1608. [Abstract] [Full Text] [PDF]

				I.-S. Chiu, J.-K. Wang, and M.-H. Wu Spiral arterial switch operation in transposition of the great arteries J. Thorac. Cardiovasc. Surg., November 1, 2002; 124(5): 1050 - 1052. [Full Text] [PDF]

				T. Kuehne, M. Saeed, G. Reddy, H. Akbari, K. Gleason, D. Turner, D. Teitel, P. Moore, and C. B. Higgins Sequential Magnetic Resonance Monitoring of Pulmonary Flow With Endovascular Stents Placed Across the Pulmonary Valve in Growing Swine Circulation, November 6, 2001; 104(19): 2363 - 2368. [Abstract] [Full Text] [PDF]

				T. Kuehne, M. Saeed, P. Moore, K. Gleason, G. Reddy, D. Teitel, and C. B. Higgins Influence of Blood-Pool Contrast Media on MR Imaging and Flow Measurements in the Presence of Pulmonary Arterial Stents in Swine Radiology, May 1, 2002; 223(2): 439 - 445. [Abstract] [Full Text] [PDF]