Multidirectional flow analysis by cardiovascular magnetic resonance in aneurysm development following repair of aortic coarctation
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Published:2008-06-08
Issue:1
Volume:10
Page:
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ISSN:1532-429X
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Container-title:Journal of Cardiovascular Magnetic Resonance
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language:en
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Short-container-title:J Cardiovasc Magn Reson
Author:
Frydrychowicz Alex,Arnold Raoul,Hirtler Daniel,Schlensak Christian,Stalder Aurelien F,Hennig Jürgen,Langer Mathias,Markl Michael
Abstract
Abstract
Aneurysm formation is a life-threatening complication after operative therapy in coarctation. The identification of patients at risk for the development of such secondary pathologies is of high interest and requires a detailed understanding of the link between vascular malformation and altered hemodynamics. The routine morphometric follow-up by magnetic resonance angiography is a well-established technique. However, the intrinsic sensitivity of magnetic resonance (MR) towards motion offers the possibility to additionally investigate hemodynamic consequences of morphological changes of the aorta.
We demonstrate two cases of aneurysm formation 13 and 35 years after coarctation surgery based on a Waldhausen repair with a subclavian patch and a Vosschulte repair with a Dacron patch, respectively. Comprehensive flow visualization by cardiovascular MR (CMR) was performed using a flow-sensitive, 3-dimensional, and 3-directional time-resolved gradient echo sequence at 3T. Subsequent analysis included the calculation of a phase contrast MR angiography and color-coded streamline and particle trace 3D visualization. Additional quantitative evaluation provided regional physiological information on blood flow and derived vessel wall parameters such as wall shear stress and oscillatory shear index.
The results highlight the individual 3D blood-flow patterns associated with the different vascular pathologies following repair of aortic coarctation. In addition to known factors predisposing for aneurysm formation after surgical repair of coarctation these findings indicate the importance of flow sensitive CMR to follow up hemodynamic changes with respect to the development of vascular disease.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology
Reference28 articles.
1. Webb GD, Smallhorn JF, Therrien J, Redington AN: Diseases of the Heart, Pericardium, and Pulmonary Vasculature Bed. Braunwald's heart disease: a textbook of cardiovascular medicine. Edited by: Libby P, Bonow RO, Mann DL, Zipes DP. 2008, 1605-1608. 8 2. de Divitiis M, Pilla C, Kattenhorn M, Zadinello M, Donald A, Leeson P, Wallace S, Redington A, Deanfield JE: Vascular dysfunction after repair of coarctation of the aorta: impact of early surgery. Circulation. 2001, 104 (12 Suppl 1): I165-170. 3. Oliver JM, Gallego P, Gonzalez A, Aroca A, Bret M, Mesa JM: Risk factors for aortic complications in adults with coarctation of the aorta. J Am Coll Cardiol. 2004, 44 (8): 1641-1647. 10.1016/j.jacc.2004.07.037. 4. Ou P, Celermajer DS, Mousseaux E, Giron A, Aggoun Y, Szezepanski I, Sidi D, Bonnet D: Vascular remodeling after "successful" repair of coarctation: impact of aortic arch geometry. J Am Coll Cardiol. 2007, 49 (8): 883-890. 10.1016/j.jacc.2006.10.057. 5. von Kodolitsch Y, Aydin MA, Koschyk DH, Loose R, Schalwat I, Karck M, Cremer J, Haverich A, Berger J, Meinertz T, Nienaber CA: Predictors of aneurysmal formation after surgical correction of aortic coarctation. J Am Coll Cardiol. 2002, 39 (4): 617-624. 10.1016/S0735-1097(01)01784-3.
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