Abstract 15783: Cardiac Fusion Imaging With Computed Tomography and Doppler Echocardiography in the Assessment of Right Ventricular Outflow Tract Obstruction in Oatients With Adult Congenital Heart Disease
Backgrounds: Echocardiographic visualization of right ventricular outflow tract (RVOT) in patients with adult congenital heart disease (ACHD) is sometimes difficult and misleading because of the poor image quality after surgery or with abnormal position of the heart. Recently, an innovative imaging technique has been developed to display in real time a virtual multi-planar reconstruction obtained from contrast-enhanced multidetector-computed tomography (MDCT) corresponding to the same cross-sectional image from echocardiography (Smart Fusion, Toshiba). The aim of this study is to assess the usefulness of this fusion imaging in the assessment of RVOT obstruction (RVOTO) / pulmonary stenosis (PS) in a patient with ACHD.
Methods: Smart fusion imaging obtained in 37 patients with ACHD who underwent TTE and MDCT within a week from January 2015 to December 2016, were analyzed in this study. Of those, 6 patients (4 women, 33±12 years, 5; after Rastelli procedure, 1; after RVOT reconstruction) with suspected RVOTO/PS were included in this study. The location of RVOTO/PS, peak pressure gradient was evaluated with/without fusion imaging.
Results: Fusion imaging was safe and feasible in all patients with ACHD. Identification of precise location of RVOTO/PS was difficult because of poor image quality in all 6 patients without fusion imaging. This integrated fusion imaging combined with Doppler echocardiography provided precise location of RVOTO/PS in all 6 patients, and also revealed significantly higher RVOT pressure gradient in 2/6 patients (Case 1; peak gradient 52 → 81mmHg,Case2:81 → 100mmHg)), resulted in reclassification of RVOTO/PS severity in 1 patient (Case1; moderate → severe).)
Conclusion: Combined with Doppler echocardiography, this novel cardiac fusion imaging is clinically useful for the assessment of precise location and severity of RVOTO/PS.
Author Disclosures: H. Oe: None. N. Watanabe: None. T. Miyoshi: None. S. Takahashi: None. Y. Ohno: None. Y. Koide: None. T. Miki: None. K. Nakagawa: None. N. Nishii: None. T. Akagi: None. H. Ito: None.
- © 2016 by American Heart Association, Inc.