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MR Coronary Angiography and Late-Enhancement Myocardial MR in Children Who Underwent Arterial Switch Surgery for Transposition of Great Arteries¹

¹ From the Departments of Radiology (A.M.T., S.D., P.H., J.B.) and Pediatric Cardiology (M.G., L.M.), Gasthuisberg University Hospital, Leuven, Belgium; Cardiothoracic Unit, Institute of Child Health and Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, England (A.M.T.); and Cardiac MR Research Group, Division of Imaging Sciences, Guy’s Hospital, London, England (A.M.T., R.R.). Received December 19, 2003; revision requested February 26, 2004; revision received April 19; accepted May 24. Supported in part by a grant from the Belgian Foundation for Research in Pediatric Cardiology. A.M.T. supported by a Marie-Curie Fellowship of the European Commission. L.M. is a clinical researcher for the Fund for Scientific Research (FWO). Address correspondence to A.M.T. (e-mail: a.taylor@ich.ucl.ac.uk).

PURPOSE: To prospectively evaluate the feasibility of magnetic resonance (MR) coronary artery imaging and to define myocardial damage with late-enhancement myocardial MR imaging in children who underwent arterial switch surgery for transposition of the great arteries.

MATERIALS AND METHODS: The local research ethics committee approved this study, and the subjects and/or a parent or guardian gave informed consent. Sixteen asymptomatic subjects who had undergone arterial switch surgery for transposition of the great arteries were studied (mean age, 10.8 years ± 1.3; 11 male subjects, five female subjects). MR coronary angiography, late-enhancement MR imaging, global ventricular function, and regional wall motion were assessed. Fifteen children were awake during imaging; one was imaged with the use of general anesthetic.

RESULTS: In 23 (72%) of 32 coronary arteries imaged, diagnostic-quality images of the coronary ostium and proximal coronary artery course were acquired; this increased to 100% in subjects older than 11 years. No coronary ostial stenoses were seen. In all subjects, the proximal course of the coronary arteries was visualized. Two subendocardial viability defects were detected, which corresponded to known compromise of the artery that supplied that territory at the time of surgery. Global left and right ventricular function were preserved, with no regional wall abnormalities.

CONCLUSION: Diagnostic-quality MR coronary angiography is feasible in subjects who have undergone arterial switch surgery for transposition of the great arteries, with no unexpected areas of myocardial infarction detected.

© RSNA, 2004

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