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Myocardial perfusion magnetic resonance imaging for detecting coronary function anomalies in asymptomatic paediatric patients with a previous arterial switch operation for the transposition of great arteries

Published online by Cambridge University Press:  26 April 2010

B. Manso ,
A. Castellote ,
L. Dos  and
J. Casaldáliga
B. Manso*
Affiliation:
Department of Pediatric Cardiology, ACOR, Hospital Universitario Materno-Infantil Vall d’Hebron, Barcelona, Spain
A. Castellote
Affiliation:
Radiology Department, Hospital Universitario Materno-Infantil Vall d’Hebron, Barcelona, Spain
L. Dos
Affiliation:
Adult Congenital Heart Disease Unit, ACOR, Hospital Universitario Vall d’Hebron, Barcelona, Spain
J. Casaldáliga
Affiliation:
Adult Congenital Heart Disease Unit, ACOR, Hospital Universitario Vall d’Hebron, Barcelona, Spain
*
Correspondence to: D. B. Manso, Department of Pediatric Cardiology, ACOR, Hospital Materno-Infantil Vall d’Hebron, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain. Tel: +34 93 27467-77; Fax: +34 93 27467 75; E-mail: bmanso@vhebron.net
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Abstract

Background

The main cause of long-term morbidity and mortality after the arterial switch operation for transposition of great arteries is complication at the coronary arteries. Myocardial perfusion magnetic resonance imaging represents a relatively novel and appealing tool for detecting myocardial ischaemia but with little experience in paediatric patients. The purpose of this paper is to report a single centre experience with myocardial perfusion magnetic resonance imaging for detecting ischaemia after the arterial switch operation for transposition of great arteries.

Methods

Twenty-eight patients aged 13–16 years with an arterial switch operation for transposition of great arteries were included in the study. Coronary pattern, operative and postoperative complications, and long-term follow-up events were reviewed. Patient functional evaluation included clinical examination, electrocardiogram and echocardiogram. Every patient underwent magnetic resonance imaging perfusion scanning at rest and under adenosine-induced stress.

Results

All patients were symptom free with no ischaemic signs on the electrocardiogram. All magnetic resonance imaging examinations were generally well tolerated with minor adenosine secondary effects in 36% of the patients. Two stress myocardial perfusion magnetic resonance studies were excluded from analysis for technical reasons. No perfusion stress defects were detected at the remaining 26. Myocardial delayed enhancement was performed in all 28 patients. In five subjects, a subendocardial late enhancement consistent with patch tissue for septal defect closure at the time of repair was indentified.

Conclusion

Magnetic resonance imaging evaluation of myocardial perfusion and viability is feasible in paediatric patients long after arterial switch operation. No signs of myocardial ischaemia or necrosis were documented in this young asymptomatic population. Further studies including coronary angiography correlation are needed to validate magnetic resonance imaging results.

Keywords

Transposition of great arteriescoronary artery diseasemyocardial perfusion magnetic resonance imaging
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 4 , August 2010 , pp. 410 - 417
Copyright
Copyright © Cambridge University Press 2010

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References

1. Wernovsky, G, Mayer, JE, Jonas, RA, et al. Factors influencing early and late outcome of the arterial switch operation for transposition of great arteries. J Thorac Cardiovas Surg 1995; 109: 289–302.Google Scholar
2. Mussatto, K, Wernovsky, G. Challenges facing the child, adolescent and young adult after ASO. Cardiol Young 2005; 15 (Suppl 1): 111–121.Google Scholar
3. Legendre, A, Losay, J, Touchot-Kone, A, et al. Coronary events after arterial switch operation for transposition of great arteries. Circ 2003; 108 (Suppl II): II-186–II-190.Google Scholar
4. Tanel, RE, Wernovsky, G, Landzberg, J, et al. Coronary artery abnormalities detected al cardiac catheterization following arterial switch operation for transposition of great arteries. Am J Cardiol 1995; 76: 153–157.Google Scholar
5. Cohen, MS, Wernovsky, G. Is the arterial switch operation as good over the long term as we thought it would be?. Cardiol Young 2006; 16 (Suppl 3): 117–124.CrossRefGoogle Scholar
6. Swada, SG, Allman, KC, Muzik, O, et al. Positron emission tomography detects evidence of viability in rest technetium-99m-sestamibi defects. JACC 1994; 23: 92–98.Google Scholar
7. Rickers, C, Sasse, K, Buchert, R, et al. Myocardial viability assessed by PET in infants and children after ASO and suspected infarction. JACC 2000; 36: 1676–1683.Google Scholar
8. Ibrahim, T, Nekolla, SG, Schreiber, K, et al. Assessment or coronary flow reserve: comparison between contrast-enhance magnetic resonance imaging and PET. JACC 2002; 39: 864–870.Google Scholar
9. Dayanikli, F, Grambow, D, Muzic, O, et al. Early detection of abnormal coronary flow reserve in asymptomatic men at high risk for coronary artery disease using positron emission tomography. Circulation 1994; 90: 808–817.Google Scholar
10. Lauerma, K. Magnetic resonance of the failing heart. Scand J Plast Reconstr Surg 2007; 96: 102–106.Google Scholar
11. Taylor, A, Dimarkowsky, S, Hamaekers, H, et al. MR coronary angiography and late-enhancement myocardial MR in children who underwent ASO for TGA. Radiology 2005; 234: 542–547.Google Scholar
12. Prakash, A, Powell, A, Krishnamurthy, R, Geva, T. Magnetic resonance imaging evaluation of miocardial perfusion and viability in congenital and acquired pediatric heart disease. Am J Cardiol 2004; 93: 657–661.Google Scholar
13. Crean, A, Merchant, N. MR perfusion and delayed enhancement imaging in the heart. Clin Radiol 2006; 61: 225–236.Google Scholar
14. Tsuda, E, Imakita, M, Yagihara, T, et al. Late death after arterial switch operation for transposition of great arteries. Am heart J 1992; 124: 1551–1557.Google Scholar
15. Planche, C, Bruniaux, J, Lacour-Gayet, F, et al. Switch operation for transposition of great arteries in neonates. J Thorac cardiovasc Surg 1988; 96: 354–363.Google Scholar
16. Kirklin, JW, Blackstone, EH, Tchervenkov, CI, Castañeda, AR, The congenital Heart Surgeon Society. Clinical outcomes after the arterial switch operation for transpositions: patients, support, procedural, and institutional risk factors. Circulation 1992; 86: 1501–1515.Google Scholar
17. Losay, J, Touchot, A, serraf, A, et al. Late outcome after arterial switch operation: for transposition of great arteries. Circulation 2001; 104: 121–126.Google Scholar
18. Brown, JW, Park, HJ, Turrentine, MW. Arterial switch operation: factors impacting survival in the current era. Ann Thorac Surg 2001; 71: 1978–1984.Google Scholar
19. Angeli, E, Raisky, O, Bonnet, D, Sidi, D, Vouhé, P. Late reoperations after neonatal arterial switch operation for transposition of great arteries. Eur J Cardio-Thorac Surg 2008; 34: 32–36.Google Scholar
20. Brutel de la Riviere, A, Quaegebeur, JM, Brutel de la Riviere, G, et al. Growth of an aorta-coronary anastomosis: an experimental study in pigs. J Thorac Cardiovas Surg 1983; 86: 393–399.CrossRefGoogle ScholarPubMed
21. Bartolani, G, Bianca, S, Patane, L, Mignosa, C. Pathology of coronary narrowing after arterial switch operation: autopsy findings in 2 patient who died within 3 months of surgical treatment and review of the literature. Cardiovasc pathology 2006; 15: 49–54.CrossRefGoogle Scholar
22. Von Bernuth, G. 25 years after the first arterial switch procedure: mid-term results. Thorac Cardiov Surg 2000; 48: 228–232.Google Scholar
23. Hutter, PA, Bennink, GBWE, Ay, L, Raes, I, Hitchcock, JF, Meijboom, . Influence of coronary anatomy and reimplantation on the long term outcome of the arterial switch. Eur J Cardiothorac surg 2000; 18: 207–213.CrossRefGoogle Scholar
24. Bonnet, D, Bonhoeffer, P, Piechaud, JF, et al. Long-term fate of the coronary arteries after ASO in newborns with TGA. Heart 1996; 76: 274–279.Google Scholar
25. Bonhoeffer, P, Bonnet, D, Piechaud, JF, et al. Coronary artery obstruction after the arterial switch operation for transposition of great arteries in newborns. JACC 1997; 29: 202–206.Google Scholar
26. Mavroudis, C, Backer, CL, Muster, AJ, et al. Expanding indications for pediatric coronary artery bypass. J Thorac Cardiovasc Surg 1996; 111: 181–189.Google Scholar
27. Raisky, O, Bergoend, E, Agnoletti, G, et al. Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization. Eur J Card-Thorac Surg 2007; 31: 894–898.Google Scholar
28. Kim, RJ, Fieno, DS, Parrish, TB, et al. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation 1999; 100: 1992–2002.CrossRefGoogle ScholarPubMed
29. Oshinski, JN, Yang, Z, Jones, JR, Mata, JF, French, BA. Imaging time after Gd-DTPA injection is critical in using delayed enhancement to determine infarct size accurately with MRI. Circulation 2001; 104: 2838–2842.CrossRefGoogle Scholar
30. Crean, A, Graves, M, Sonnex, E, et al. Diagnostic accuracy of cardiac MRI stress perfusion with first-pass gadolinium enhancement: experience in the first 56 cases. Heart 2003; 89: A43.Google Scholar
31. Nagel, E, Klein, C, Paetsch, I, et al. Perfusion measurements for the detection of coronary artery disease. J Cardiovasc Magn Reson 2003; 5: 89–90.Google Scholar
32. Giang, T, Nanz, D, Coulden, R, et al. Detection or coronary artery disease by magnetic resonance myocardial perfusion imaging with various contrast medium doses: first European multi-centre experience. Eur Heart J 2004; 25: 1657–1665.Google Scholar
33. Acar, P, Maunoury, C, Bonnet, D, et al. Comparison of myocardial SPETC with coronary artery angiography after arterial switch operation. JACC 2001; 87: 1425–1427.Google Scholar
34. Hayes, A, Baker, E, Kakadeker, A, et al. Influence of anatomic correction for transposition of great arteries on myocardial perfusion: radionuclide Imaging with technetium-99m 2-methoxy isobutyl isonitrile. J Am Coll Cardiol 1994; 24: 769–777.Google Scholar
35. Weidiling, SN, Wernovsky, G, Colan, SD, et al. Myocardial perfusion, function and exercise tolerance after the arterial switch operation. JACC 1994; 23: 424–433.Google Scholar
36. Hauser, M, Bengel, FM, Kuhn, A, et al. Myocardial blood flow and flow reserve after coronary reimplantation in patients after arterial switch and Ross operation. Circulation 2001; 103: 1875–1880.Google Scholar
37. Bengel, F, Hauser, M, Duvernoy, C, et al. Myocardial blood flow and coronary reserve late after anatomical correction of transposition of great arteries. JACC 1998; 32: 1955–1961.Google Scholar
38. Yates, M, Mardsen, PK, Badawi, RD, et al. Evaluation of myocardial perfusion using positron emission tomography in infants following neonatal arterial switch operation. Pediatr Cardiol 2000; 21: 111–118.CrossRefGoogle ScholarPubMed
39. Gagliardi, MG, Adorisio, R, Crea, F, Versacci, P, Donato, R, Sanders, S. Abnormal vasomotor function of the epicardial coronary arteries in children 5–8 years after arterial switch operation. JACC 2005; 46: 1565–1571.Google Scholar
40. Schwitter, J, Nanz, D, Kneifel, S, et al. Assessment of myocardial perfusion in coronary artery disease by magnetic resonance. A comparison with positron emission tomography and coronary angiography. Circulation 2001; 103: 2230–2235.Google Scholar
41. Kuhl, HP, Beek, AM, van der Weerdt, , et al. Myocardial viability in chronic ischemic heart disease: comparison of contrast-enhanced magnetic resonance imaging with (18)-F-fluorodeoxyglucose positron emission tomography. JACC 2003; 41: 1341–1348.Google Scholar
42. Hendel, RC, Berman, DS, Cullom, SJ, et al. Multicentral clinical trial to evaluate the efficacy of correction for photon attenuation and scatter in SPECT in myocardial perfusion imaging. Circulation 1999; 99: 2742–2749.Google Scholar
43. Pasquali, S, Hasselblad, V, Li, JS, Kong, DF, Sanders, S. Coronary artery pattern and outcome of arterial switch operation for transposition of great arteries: meta-analysis. Circ 2002; 106(20): 2575–2580.CrossRefGoogle ScholarPubMed
44. Tamisier, D, Ouaknine, R, Pouard, P, et al. Neonatal arterial switch operation: coronary artery patterns and coronary events. Eur J Cardiothorac Surg 1997; 11: 810–817.CrossRefGoogle ScholarPubMed
45. Mayer, JE, Sanders, SP, Jonas, RA, Castañeda, AR, Wernovsky, G. Coronary artery pattern and outcome of arterial switch operation for transposition of great arteries. Circulation 1990; 82 (Suppl IV): 139–145.Google Scholar