Page 23 - Journal of Structural Heart Disease Volume 5, Issue 3

Original Scientific Article
Journal of Structural Heart Disease, June 2019, Volume 5, Issue 3:62-69
DOI: https://doi.org/10.12945/j.jshd.2019.028.18
Received: August 15, 2018 Accepted: September 19, 2018 Published online: June 2019
Correlation and Agreement of Steady-State Free Processed Imaging Cardiac Magnetic Resonance Imaging and Balloon Waist Diameter of the Right Ventricular Outflow Tract for Percutaneous Pulmonary Valve Replacement
Joshua David Kurtz, MD*, Anthony M. Hlavacek, MD, George Hamilton Baker, MD
Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA
Abstract
Background: Percutaneous pulmonary valve replace- ment (PPVR) candidacy is limited by right ventricular outflow tract (RVOT) diameter.
Objective: We examined the correlation and agree- ment of RVOT minimal diameter measured by MRI and balloon waist diameter (BWD) during PPVR.
Methods: This is a single center, retrospective study of patients undergoing PPVR who had a cardiac MRI per- formed within one year prior to the procedure. All MRI measurements were made by a single investigator at the narrowest location of the RVOT during peak systo- le in two orthogonal planes using three separate MRI sequences. BWD was defined as the narrowest point in the sizing balloon at full inflation within the RVOT. The primary outcome was the agreement of MRI and BWD measurements of the RVOT.
Results: Twenty-three patients were included in the analysis. Twelve (52%) were male, 17 (74%) had a diag- nosis of tetralogy of Fallot, 4 (17%) did not have a valve placed due to RVOT size. The average age was 31 years (9-56 years old). BWD measurements had a significant correlation with both planes of stacked cine steady- state free precession imaging MRI and the larger diame- ter of MR angiography. BWD had significant agreement
with both stacked cine steady-state free precession im- aging MRI planes by Bland-Altman analysis.
Conclusions: MRI measurements show moderate cor- relation and agreement with BWD of the RVOT. While the mean difference is small, the range of agreement is quite wide. This suggests MRI is only moderately effec- tive in determining RVOT diameter candidacy in PPVR. Further study is warranted to determine the most ef- fective method for RVOT diameter selection in PPVR. Copyright © 2019 Science International Corp.
Key Words
Percutaneous Pulmonary valve replacement • Tetralogy of Fallot • Right ventricular outflow tract dysfunction • Pulmonary regurgitation • Cardiac magnetic resonance imaging
Introduction
Corrective surgery for patients with diseases of the pulmonary valve (PV) and right ventricular outflow tract (RVOT), has improved significantly over recent decades. Despite advances in techniques that have led to significant improvements in morbidity, mor- tality, and quality of life for these patients, many will require future procedures due to residual pulmonary
* Corresponding Author:
Joshua David Kurtz, MD
Division of Pediatric Cardiology
Medical University of South Carolina
165 Ashley Ave MSC 915, Charleston, SC 29425, USA
Tel.: +1 843 834 0972; Fax: +1 843 792 5878; E-Mail: kurtzj@musc.edu
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2019 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004
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