ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Kirk R. Kanter
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Riehle, T. J.
Right arrow Articles by Parks, W. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Riehle, T. J.
Right arrow Articles by Parks, W. J.
Related Collections
Right arrow Congenital - acyanotic

Ann Thorac Surg 2006;81:1002-1007
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Velocity-Encoded Magnetic Resonance Image Assessment of Regional Aortic Flow in Coarctation Patients

Tiffany J. Riehle, MD a , c , John N. Oshinski, PhD a , Marijn E. Brummer, MD a , Jennifer Favaloro-Sabatier, MApStat a , William T. Mahle, MD b , c , Derek A. Fyfe, MD, PhD b , c , * , Kirk R. Kanter, MD a , c , W. James Parks, MD b , c

a Emory University School of Medicine, Atlanta, Georgia
b Sibley Heart Center Cardiology, Atlanta, Georgia
c Children's Healthcare of Atlanta, Atlanta, Georgia

Accepted for publication July 5, 2005.

* Address correspondence to Dr Fyfe, Children's Healthcare of Atlanta, Department of Cardiology, 1405 Clifton Rd NE, Atlanta, GA 30322 (Email: tr7766{at}aol.com).

BACKGROUND: During primary coarctation repair, collateral blood vessels contribute significantly to distal perfusion. We sought to determine if velocity-encoded cine magnetic resonance imaging (VENC-MRI) could provide insight into anatomy and hemodynamics of collateral flow in patients with unrepaired coarctation.

METHODS: Sixteen patients (median age, 6.2 years; range, 1 to 18) with discrete coarctation (65% severe, 29% mild-moderate) and 10 controls (median age, 12.0 years; range, 9 to 15) without left-sided heart lesions were referred for cardiac MRI. Flow volumes were calculated from VENC-MRI images at the coarctation (proximal), diaphragm (distal), and midway between the two points (midpoint). A means model, repeated-measure analysis, was performed for volumes.

RESULTS: In coarctation patients, flow volumes increased by 59% (p = 0.0002) from coarctation to diaphragm, primarily between the proximal and midpoint sites (by 77%, p < 0.0001). In controls, flow volumes decreased by 11% along the entire aortic study length. Coarctation volumes were lower than controls by 54% (p = 0.0003) at the proximal site but showed no statistical difference at the midpoint or diaphragm.

CONCLUSIONS: Coarctation flow volumes maximally increase in the upper thoracic aorta, but approach normal flow volumes in the lower thoracic region. Arteries arising from mid and lower thoracic level, such as those supplying the anterior spinal cord, may have nearly normal flow if collaterals are present. Velocity-encoded MRI can evaluate flow in patients who have poor collateral circulation to improve surgical planning and decrease neurologic complications of coarctation repair.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 by The Society of Thoracic Surgeons.