1. Usefulness of cardiac fusion imaging with computed tomography and Doppler echocardiography in the assessment of conduit stenosis in complex adult congenital heart disease
- Author
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Kazuhiro Osawa, Fumi Yokohama, Yoichi Takaya, Norihisa Toh, Rie Nakayama, Nobuhisa Watanabe, Hiroshi Ito, Teiji Akagi, Toru Miyoshi, and Susumu Kanazawa
- Subjects
Adult ,Heart Defects, Congenital ,Cardiac Catheterization ,medicine.medical_specialty ,Heart disease ,medicine.medical_treatment ,Computed tomography ,Constriction, Pathologic ,Doppler echocardiography ,Internal medicine ,Multidetector Computed Tomography ,medicine ,Humans ,In patient ,Cardiac catheterization ,medicine.diagnostic_test ,business.industry ,Aortic Valve Stenosis ,medicine.disease ,Echocardiography, Doppler ,Stenosis ,Echocardiography ,Peak velocity ,cardiovascular system ,Cardiology ,Tomography ,Cardiology and Cardiovascular Medicine ,business - Abstract
Noninvasive assessment of stenotic lesions in patients with complex adult congenital heart disease (ACHD) is challenging due to its complex morphology. The simultaneous two-screen display of multidetector-computed tomography (MDCT) and real-time echogram (STDME) technology can display a virtual multi-planar reconstruction from MDCT corresponding to the same cross-sectional image from transthoracic echocardiography (TTE). We investigated the usefulness of the STDME technology for stenosis severity assessment in complex ACHD patients.Twenty-four complex ACHD patients with stenotic lesions were enrolled in this study. All patients underwent TTE and the STDME technology within a week after MDCT. Peak velocity and pressure gradient (PG) across the stenotic site were measured using continuous wave Doppler. Cardiac catheterization was performed in 17 patients.Nine out of the twenty-four patients had undergone repair with a conduit. Peak velocity and PG from the STDME technology were higher than those from TTE (peak velocity: 3.1 ± 1.1 vs. 2.8 ± 1.0 m/s; peak PG: 43 ± 28 vs. 34 ± 21 mmHg; both p0.01). Peak PG from the STDME technology showed significant correlations with those from catheterization in patients with a conduit (n=7) and those without a conduit (n=10) (r = 0.795 and 0.880, respectively; both p0.05), while peak PG from TTE was correlated with catheterization measurements only in patients without a conduit (r = 0.850, p0.05).The STDME technology enables more accurate assessment of conduit stenosis severity than does TTE in complex ACHD patients.
- Published
- 2021
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