Journal article
Cardiac Magnetic Resonance to Predict Coronary Artery Compression in Transcatheter Pulmonary Valve Implantation Into Conduits
JACC. Cardiovascular interventions, Vol.15(9), pp.979-988
05/09/2022
DOI: 10.1016/j.jcin.2022.02.047
PMID: 35512922
Abstract
The aim of this study was to evaluate the accuracy of cardiac magnetic resonance (CMR) in predicting coronary artery (CA) compression during transcatheter pulmonary valve implantation (TPVi).
TPVi is a widely available option to treat dysfunctional right ventricle (RV)-to-pulmonary artery (PA) conduits, but CA compression is an absolute contraindication. CMR can evaluate coronary anatomy, but its utility in predicting CA compression is not well established.
After Institutional Review Board approval was obtained, all patients at 9 centers with attempted TPVi in RV-PA conduits and recent CMR (≤12 months) were analyzed. A core laboratory reviewed all CMR studies for the shortest orthogonal distance from a CA to the conduit, the shortest distance from a CA to the most stenotic area of the conduit, and subjective assessment of CA compression risk.
Among 231 patients, TPVi was successful in 198 (86%); in 24 (10%), balloon testing precluded implantation (documented CA compression or high risk). Distance to the RV-PA conduit ≤2.1 mm (area under the curve [AUC]: 0.70) and distance to most stenotic area ≤13.1 mm (AUC: 0.69) predicted CA compression. Subjective assessment had the highest AUC (0.78), with 96% negative predictive value. Both distances and qualitative assessment remained independently associated with CA compression when controlling for abnormal coronary anatomy or degree of conduit calcification.
CMR can help predict the risk for CA compression during TPVi in RV-PA conduits but cannot completely exclude CA compression. CMR may assist in patient selection and counseling families prior to TPVi, although balloon testing remains essential.
Details
- Title: Subtitle
- Cardiac Magnetic Resonance to Predict Coronary Artery Compression in Transcatheter Pulmonary Valve Implantation Into Conduits
- Creators
- Ryan A Romans - Sisters of Mercy Health SystemJimmy C Lu - C. S. Mott Children's HospitalSowmya Balasubramanian - C. S. Mott Children's HospitalWendy Whiteside - C. S. Mott Children's HospitalSunkyung Yu - C. S. Mott Children's HospitalOsamah T Aldoss - University of IowaAimee K Armstrong - Nationwide Children's HospitalBrian A Boe - Nationwide Children's HospitalDavid T Balzer - St. Louis Children's HospitalJason T Christensen - Children's Hospital & Medical CenterThomas K Jones - Seattle Children's HospitalBritton Keeshan - Yale UniversityDaniel McLennan - Division of Cardiology, Herma Heart Institute at Children’s Wisconsin, Milwaukee, Wisconsin, USAGeorge T Nicholson - Monroe Carell Jr. Children's HospitalNeil Patel - Children's Hospital of Los AngelesArash Salavitabar - Nationwide Children's HospitalShabana Shahanavaz - Cincinnati Children's Hospital Medical CenterPatrick M Sullivan - Children's Hospital of Los AngelesMariel E Turner - Columbia University Irving Medical CenterJeffrey D Zampi - C. S. Mott Children's Hospital
- Resource Type
- Journal article
- Publication Details
- JACC. Cardiovascular interventions, Vol.15(9), pp.979-988
- DOI
- 10.1016/j.jcin.2022.02.047
- PMID
- 35512922
- ISSN
- 1936-8798
- eISSN
- 1876-7605
- Language
- English
- Date published
- 05/09/2022
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984354052402771
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