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This article discusses a study that aimed to predict the hemodynamic effects of different valve sizes during aortic valve replacement (AVR) surgery. The study used computational fluid dynamics (CFD) based virtual therapy planning to simulate the impact of different valve sizes at rest and under physical stress conditions. The results showed that different valve sizes led to significantly different velocities across the left ventricular outflow tract, and stress simulation increased the gradient across the aortic valve. However, blood flow profiles in the ascending aorta remained pathological after AVR and did not change significantly under simulated physical stress. The study suggests that this methodological approach could help identify patients at risk of stress-induced patient prosthesis mismatch. [Extracted from the article]

The article discusses the use of the Lifetech KONAR-MF VSD occluder, a percutaneous closure device, in the treatment of patients with ventricular septal defect (VSD). The study aimed to collect data on the device's performance during a 12-month follow-up period. The results showed a high success rate of VSD closure without complications, with only a small number of patients experiencing residual shunting. The study concluded that the KONAR-MF VSD occluder is an effective and safe option for patients with VSD. [Extracted from the article]

Objective: To characterise 3D deformations of the right ventricular outflow tract (RVOT)/pulmonary arteries (PAs) during the cardiac cycle and estimate the errors of conventional 2D assessments.Methods: Contrast-enhanced, ECG-gated cardiovascular computed tomography (CT) findings were retrospectively analysed from 12 patients. The acquisition of 3D images over 10 phases of the cardiac cycle created a four-dimensional CT (4DCT) dataset. The datasets were reconstructed and deformation measured at various levels of the RVOT/PAs in both space and time. Section planes were either static or dynamic relative to the motion of the structures.Results: 4DCT enabled measurement and characterisation of in vivo 3D changes of patients' RVOT/PA during the cardiac cycle. The studied patient population showed a wide range of RVOT/PA morphologies, sizes and dynamics that develop late after surgical repair of congenital heart disease. There were also significant differences in the measured cross-sectional areas of the structures between static and dynamic section planes (up to 150%, p<0.05) secondary to large 3D displacements and rotations.Conclusions: 4DCT imaging data suggest high variability in RVOT/PA dynamics and significant errors in deformation measurements if 3D analysis is not carried out. These findings play an important role for the development of novel percutaneous approaches to pulmonary valve intervention. [ABSTRACT FROM AUTHOR]

Purpose: To assess the feasibility and reproducibility of real-time radial k-t sensitivity encoding (SENSE) magnetic resonance imaging (MRI) for biventricular volumetric assessment during exercise.Materials and Methods: In all, 12 healthy young adults underwent MRI at rest and during supine exercise at three different workload intensities. Biventricular volumes and function were assessed with 1) a radial k-t SENSE real-time sequence and 2) a scanner vendor supplied (standard) real-time sequence. Global image quality, motion fidelity, and agreement in right ventricular (RV) and left ventricular (LV) stroke volume (SV) as a surrogate measure for accuracy were assessed. Exercise MR was repeated within 1 month for assessment of reproducibility.Results: Imaging scores were superior for radial real-time k-t SENSE images (P < 0.001). Agreement in RV and LV SV during exercise was better with radial k-t real-time (SD of difference +/-3.43 vs. +/-8.97 mL; P < 0.001). Agreement in cardiac output (CO) in the same subject at two different imaging sessions was better for radial k-t SENSE. This was significant for the CO calculated for the RV (SD of difference +/-0.6 vs. +/-0.95 L/min; P = 0.01) and LV (+/-0.45 vs. +/-0.92 L/min; P < 0.001).Conclusion: Radial k-t SENSE real-time imaging represents a feasible and reproducible imaging technique for biventricular assessment during exercise. [ABSTRACT FROM AUTHOR]

Recent research in patients with functionally univentricular hearts (UVH) is focusing on pathologies of the lymphatic vessels. Morphology of the abdominal lymphatic vessels was analyzed by MRI in patients with UVH following total cavopulmonary connection (TCPC) and it was examined, if clinical and laboratory parameters correlate with changes after TCPC. We prospectively examined 33 patients at the age of 19.8 (14.6;30.2) years [median (Q1;Q3)] after TCPC (follow-up 14.3 years (9.7;24.9) with a heavily T2-weighted MRI sequence on a 3.0 T scanner. Examinations in coronal orientation were performed with respiratory gating, slice thickness 0.6 mm, TR 2400 ms, TE 692 ms, FoV 460 mm (covering thoracic and abdominal regions), scan time 14:41 min (13:18;16:30) after a solid meal and a cup of pineapple juice. The findings were classified according to delineation of abdominal lymphatic vessels. Type 1: <3 abdominal vessels (av) definable; type 2: 4-6 av definable; type 3: >6 av and/or oedematous changes or ascites. The results were correlated with parameters obtained at the annual routine check-up. Statistical analysis was performed using U-test and Chi-square test. Fifteen patients (group 1) showed type 3 lymphatic morphologies, two of which had ascites. Eighteen patients (group 2) showed lower grade morphologies (type 1-2). Image quality was rated considering the delineation of the common hepatic duct and did not differ between groups (p = 0.134). "Lymphatic burden" was automatically examined and was indexed to the number of delineated abdominal vessels and showed quantification according to the chosen categories type 1-3. Patients in group 1 were younger at MRI examination (17.4;14.3/18.9 vs. 26.2;18.2/32.3 years, p = 0.03). Superior cavopulmonary connection (SCPC) had been performed earlier in group 1 (9.9;7.9/25.5 vs. 29.2;13.7/66.6 months, p = 0.018). Laboratory examinations in group 1 showed lower levels for Immunoglobulin G (IgG), Lipase, α-Antitrypsin, Cystatin C and TSH. There were no significant differences for total protein, NTproBNP, lymphocytes or platelets. A history of chylothorax was present in 7/15 versus 2/18 p = 0.022. Protein-losing enteropathy (PLE) occurred in 4/15 versus 1/18 (p = 0.092). T2 weighted MRI is feasible for noninvasive delineation of abdominal lymphatic vessel in patients following TCPC. In the long-term follow-up, patients with more pronounced changes of the abdominal lymphatic vessels were younger at SCPC and were more likely to show a history of chylothorax and lower IgG values., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Consent for publication: Written informed consent was obtained from the patient for publication and any accompanying pictures. A copy of the written consent is available for review by the Editor of this journal., (© 2024. The Author(s).)