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(Circulation. 2002;105:e176.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Total Cavo-Pulmonary Connection

A Virtual 3-Dimensional Fly-Through

Thomas Sangild Sørensen, MSc; Søren Vorre Therkildsen, MSc; Ole Kromann Hansen, MD; Keld Sørensen, MD; Erik Morre Pedersen, MD, PhD, DMSc

From the Department of Cardiothoracic and Vascular Surgery (T.S.S., O.K.H., E.M.P.), Department of Cardiology (K.S., E.M.P.), and MR-Center (T.S.S., E.M.P.), Aarhus University Hospital, Skejby Sygehus; and Center for Advanced Visualization and Interaction (CAVI) (S.V.T.), Aarhus, Denmark.

Correspondence to Thomas Sangild Sørensen, CAVI, Aabogade 34, DK-8200 Aarhus N, Denmark. E-mail sangild{at}daimi.au.dk

Magnetic resonance (MR) imaging increasingly is used in subjects with congenital heart disease. Recent improvements have made it possible to acquire data for clinically useful 3D imaging. To take this even further, post-processing techniques, which allow not only external 3D imaging of the heart but also real-time, interactive, intracardial exploration of cardiac morphology, were also developed.

In this case, a 22-year-old woman underwent standard MR imaging 9 years after a lateral tunnel total cavo-pulmonary connection for tricuspid atresia as part of a routine follow-up program. From the MR volume data, a 3D virtual model of the heart was reconstructed. This model was explored using custom-designed software. The external view subsequently could be assessed interactively in real time from any point by the investigator using an intuitive interface. Furthermore, the internal morphology and relations could also be inspected in detail by zooming into any chosen cardiac structure.

An investigator-directed movie of the session was created and is available as an online Data Supplement. Two stills from the movie are shown, an external right anterior view (A) and an internal view from the apex of the left ventricle looking toward the basal part of the heart (B) (Figure).

View larger version (66K): [in this window] [in a new window]   Virtual reconstruction and exploration from cardiac MRI. The figure shows 2 stills from the online Movie, which explores morphology after a lateral tunnel total cavo-pulmonary connection. AO indicates aorta; IVC, inferior vena cava; LA, left atrium; LPA, left pulmonary artery; LV, left ventricle; MYO, myocardium; PA, pulmonary artery; RCA, right coronary artery; RPA, right pulmonary artery; RPV, right pulmonary vein; SVC, superior vena cava; TCPC, lateral tunnel total cavo-pulmonary connection; and VSD, ventricular septal defect.

Acknowledgments

This work was supported by the Danish Heart Foundation Grant No. 00-2-3-77-22867 and the Danish Medical Research Council Grant No. 28809. We thank the Center for Advanced Visualization and Interaction (CAVI) for assistance in creation of the movie.

Footnotes

The Movie is available as an online-only Data Supplement at http://www.circulationaha.org.

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sørensen, T. S. Articles by Pedersen, E. M. Search for Related Content PubMed PubMed Citation Articles by Sørensen, T. S. Articles by Pedersen, E. M. Related Collections CT and MRI Pediatric and congenital heart disease, including cardiovascular surgery