1. Three-dimensional and four-dimensional flow assessment in congenital heart disease
- Author
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Evangeline G Warmerdam, Heynric B. Grotenhuis, Tim Leiner, and Gregor J. Krings
- Subjects
Heart Defects, Congenital ,medicine.medical_specialty ,Heart disease ,advanced cardiac imaging ,cardiac magnetic resonance imaging ,Coarctation of the aorta ,Hemodynamics ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Bicuspid aortic valve ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Survival rate ,Tetralogy of Fallot ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Magnetic Resonance Imaging ,congenital heart disease ,Cardiac Imaging Techniques ,Regional Blood Flow ,Hydrodynamics ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Congenital heart disease (CHD) is the most common form of congenital defects, with an incidence of 8 per 1000 births. Due to major advances in diagnostics, perioperative care and surgical techniques, the survival rate of patients with CHD has improved dramatically. Conversely, although 70%–95% of infants with CHD survive into adulthood, the rate of long-term morbidity, which often requires (repeat) intervention, has increased. Recently, the role of altered haemodynamics in cardiac development and CHD has become a subject of interest. Patients with CHD often have abnormal blood flow patterns, either due to the primary cardiac defect or as a consequence of the surgical intervention(s). Research suggests that these abnormal blood flow patterns may contribute to diminished cardiac and vascular function. Serial assessment of haemodynamic parameters in patients with CHD may allow for improved understanding of the often complex haemodynamics in these patients and thereby potentially guide the timing and nature of interventions with the aim of preventing progression of cardiovascular deterioration. In this article we will discuss two novel non-invasive four-dimensional (4D) techniques to evaluate cardiovascular haemodynamics: 4D-flow cardiac magnetic resonance and computational fluid dynamics. This review focuses on the additional value of these two modalities in the evaluation of patients with CHD with abnormal flow patterns, who could benefit from advanced haemodynamic evaluation: patients with coarctation of the aorta, bicuspid aortic valve, tetralogy of Fallot and patients after Fontan palliation.
- Published
- 2019
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