Preoperative evaluation of pulmonary artery morphology and pulmonary circulation in neonates with pulmonary atresia - usefulness of MR angiography in clinical routine.
Summary of "Preoperative evaluation of pulmonary artery morphology and pulmonary circulation in neonates with pulmonary atresia - usefulness of MR angiography in clinical routine."
ABSTRACT:
BACKGROUND:
To explore the role of contrast-enhanced magnetic resonance angiography (CE-MRA) in clinical routine for evaluating neonates with pulmonary atresia (PA) and to describe their pulmonary artery morphology and blood supply. CE-MRA studies of 15 neonates with PA (12 female; median weight: 2900g) were retrospectively evaluated by two radiologists in consensus. Each study was judged to be either diagnostic or non-diagnostic depending on the potential to evaluate pulmonary artery morphology and pulmonary blood supply. In those cases where surgery or conventional angiocardiography was performed results were compared.
RESULTS:
CE-MRA was considered diagnostic in 87%. Pulmonary artery morphology was classified as "confluent with (n=1) and without (n=1) main pulmonary artery", "non-confluent" (n=6) or "absent" (n=7). Source of pulmonary blood supply was "a persistent arterial duct" (n=12), "a direct" (n=22) or "indirect (n=9) aortopulmonary collateral artery (APCA)" or "an APCA from the ascending aorta" (n=2). In no patient were there any additional findings at surgery or conventional angiocardiography which would have changed the therapeutic or surgical approach.
CONCLUSIONS:
CE-MRA is a useful diagnostic tool for the preoperative evaluation of the morphology of pulmonary arteries and blood supply in neonates with PA. In most cases diagnostic cardiac catheterization can be avoided.
Affiliation
Journal Details
This article was published in the following journal.
Name: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
ISSN: 1532-429X
Pages: 52
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20843357
- DOI: http://dx.doi.org/10.1186/1532-429X-12-52
Medical and Biotech [MESH] Definitions
Pulmonary Subvalvular Stenosis
Narrowing below the PULMONARY VALVE or well below it in the infundibuluar chamber where the pulmonary artery originates, usually caused by a defective VENTRICULAR SEPTUM or presence of fibrous tissues. It is characterized by restricted blood outflow from the RIGHT VENTRICLE into the PULMONARY ARTERY, exertional fatigue, DYSPNEA, and chest discomfort.
Catheterization, Swan-ganz
Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery.
Blalock-taussig Procedure
A cardiovascular procedure performed to create a blood supply to the PULMONARY CIRCULATION. It involves making a connection between the subclavian, or carotid branch of the AORTA, or the AORTIC ARCH to the PULMONARY ARTERY.
Transposition Of Great Vessels
A congenital cardiovascular malformation in which the AORTA arises entirely from the RIGHT VENTRICLE, and the PULMONARY ARTERY from the LEFT VENTRICLE. Consequently, the pulmonary and the systemic circulations are parallel and not sequential, so that the venous return from the peripheral circulation is re-circulated by the right ventricle via aorta to the systemic circulation without being oxygenated in the lungs. This is a potentially lethal form of heart disease in newborns and infants.
Pulmonary Valve Insufficiency
Backflow of blood from the PULMONARY ARTERY into the RIGHT VENTRICLE due to imperfect closure of the PULMONARY VALVE.
PubMed Articles
Surgical correction of isolated unilateral absence of right pulmonary artery.
A 2-year-old girl with isolated unilateral absence of right pulmonary artery is described. Catheterization at 5 months demonstrated hypoplastic right pulmonary artery by pulmonary venous wedge angiogr...
Isolated Unilateral Agenesis of the Pulmonary Artery: Surgical Repair With an Artificial Graft.
This report describes a 3-month-old Japanese boy with a diagnosis of isolated unilateral agenesis of the proximal right pulmonary artery with severe pulmonary hypertension. One-stage reconstruction of...
Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series.
ABSTRACT: INTRODUCTION: Pulmonary artery aneurysm is an uncommon disorder with severe complications. The diagnosis is often difficult, since the clinical manifestations are non-specific and the treatm...
Anomalous Left Pulmonary Artery Without Sling Formation.
A case of aberrant left pulmonary artery originating from the right pulmonary artery resembling pulmonary artery sling malformation, but without true sling formation, is presented. Anomalous left pulm...
We present a coincidental finding of quadricuspid pulmonary valve and left pulmonary artery aneurysm. As both the pulmonary valve and the pulmonary trunk with its main branches are hard to visualise w...
Clinical Trials
Effects of Bosentan (Tracleer) in the Course of Pulmonary Artery Hypertension Induced by Hypoxia
Excessive rise in pulmonary artery pressure induced by low oxygen tension (hypoxia) is one of the factors implicated in high-altitude pulmonary oedema. Plasma ET1 increases in subjects ex...
The study objective is to determine the safety up to 18 months of age of the extended use of 0.2 mg/kg/day clopidogrel in patients included in CLARINET study (EFC5314) with cyanotic congen...
Sildenafil for Chronic Obstructive Pulmonary Disease (COPD) Associated Pulmonary Hypertension
Chronic obstructive pulmonary disease (COPD)can be complicated by an increased pressure in the pulmonary circulation. This worsens the prognosis, but so far it is unknown whether treatment...
Monitoring Pulmonary Artery Pressure by Implantable Device Responding to Ultrasonic Signal
This study will evaluate an implantable pulmonary artery pressure sensor in patients with heart failure.
The Role of Endothelin in Pulmonary Hypertension
The purpose of the study is is to determine the effect, on the lung circulation, of BQ-123, an investigational compound which is not approved by the FDA.
