Page 91 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
120. Table 1. Representative locations for 2D and 3D measurements.
Results:
CA vs 0.5 [0.8] 3DRA
MSCT vs -0.3 [0.8] 3DRA
0.2 [0.4] 0.0 [0.2]
0.7 [1.4] 0.88 0.7 [1.6] 0.85
Mean difference Stent [std] (mm)
Mean difference Stenosis [std] (mm)
Mean difference All PA segments [std] (mm)
R2 All PA segments
120. Figure 1.
measures. The study purpose is to investigate the diagnos- tic reliability of 3DRA compared to CA and MSCT for quan- tification of PA morphology in a swine model of PA stenosis ± PA stent interventions.
Methods: Sixteen anesthetized 20-week old swine (55 ± 9 Kg - 4 sham controls, 4 untreated proximal LPA stenosis and 8 stented proximal LPA) had CA, MSCT and 3DRA. MSCT was performed using a 64-slice CT scanner (GE 750 CT, GE Healthcare, Waukesha, WI) using retrospective cardiac gating. Scan variables included: collimation 40mm, slice thickness 0.625 mm, 140 kV (peak), tube current 570 mA, acquisition diameter 29cm and 512x512 reconstruction matrix. CA and 3DRA was performed on a single plane Artis Z system (Siemens Healthcare. Forchheim, Germany). CA was acquired with caudal and LAO angulation to profile the proximal LPA. 3DRA utilized a 200o rotation over 5 sec at 60 frames/sec with contrast injection preceding image acqui- sition by 1 sec with simultaneous IVC balloon occlusion.
Quantification of PA measurements were evaluated independently in the following locations: Proximal LPA, RPA, LPA/RPA adjacent to two first order branches and diameters of two proximal RPA/LPA first order branches (Figure 1). CA measurement was performed on the Seimens workstation. Orthogonal planes of the areas
of interest were generated from post processing multi- planer reformatting tools for MSCT (McKesson Technology Solutions. Alpharetta, GA) and 3DRA (Mimics Materialise Medical. Plymouth, MI) from which maximum PA dimen- sions were recorded. Differences in vessel diameters between modalities was assessed using a Bland-Altman difference analysis. There was excellent correlation between 3DRA to both CA and MSCT for quantification of mean differences in PA dimensions for all measured seg- ments (Table 1) although systematically 3DRA trended toward smaller measures. Similar agreement in mean PA dimensions existed in stenotic (1.4±0.1, 1.6±0.3, 1.7±0.1 mm) and stented (9.7±1.0, 10.2±1.0, 10.2±0.8 mm) PA seg- ments when comparing 3DRA to MSCT and CA.
Conclusion: These findings show strong correlation in vessel diameters between 3DRA, CA and MSCT in normal, stenotic and stented PAs. This study demonstrates the fea- sibility of 3DRA to accurately assess PA size and morphol- ogy in an animal model of CHD.
121. NATIVE RIGHT VENTRICULAR OUTFLOW TRACT (NRVOT) DYSFUNCTION TREATED WITH THE ALTERRA ADAPTIVE PRESTENT AND SAPIEN 3: PATIENT SELECTION AND DEVICE SIZING
Shabana Shahanavaz1, David Balzer2, Vivian Dimas3, Vasilis C. Babaliaros4, Dennis Kim5, Kelly Han6, Philipp Blanke7, Jeremy Gorelick8, Evan Zahn9
1Washington University in St. Louis School of Medicine, St. Louis, USA. 2Washington University in St. Louis School of Medicine,
St. Louis, MO, USA. 3Children’s Medical Center UT Southwestern Medical Center, Dallas, TX, USA. 4Emory University, Atlanta,
GA, USA. 5Children’s Healthcare of Atlanta, Atlanta, GA, USA. 6Minneapolis Heart Institute, Minneapolis, MN, USA. 7University of British Columbia and St. Paul's Hospital, Vancouver, BC,
Hijazi, Z
22nd Annual PICS/AICS Meeting