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Journal of Structural Heart Disease, June 2019, Volume 5, Issue 3:62-69
DOI: 10.12945/j.jshd.2019.028.18

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

Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA

Abstract

Background: Percutaneous pulmonary valve replacement (PPVR) candidacy is limited by right ventricular outflow tract (RVOT) diameter.

Objective: We examined the correlation and agreement 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 performed 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 systole 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 diagnosis 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 diameter of MR angiography. BWD had significant agreement 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, mortality, and quality of life for these patients, many will require future procedures due to residual pulmonary with both stacked cine steady-state free precession imaging MRI planes by Bland-Altman analysis.

Conclusions: MRI measurements show moderate correlation 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 effective in determining RVOT diameter candidacy in PPVR. Further study is warranted to determine the most effective method for RVOT diameter selection in PPVR.

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Cite this article as: Kurtz JD, Hlavacek AM, Baker GH. 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. Structural Heart Disease 2019;5(3):62-69. DOI: 10.12945/j.jshd.2019.028.18

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