Key result
Noninvasive imaging techniques, including CMR, CT, and fusion imaging, are efficient and reliable tools for pre-procedural planning in patients assessed for percutaneous pulmonary valve replacement.
Why the study?
Percutaneous pulmonary valve replacement requires careful and reliable pre-interventional imaging to select suitable candidates and minimize complications given anatomical variability of the RVOT, coronary arteries, and pulmonary branches.
What is the role of noninvasive imaging prior to percutaneous pulmonary valve replacement in patients with congenital heart disease?
What is the role of noninvasive imaging prior to percutaneous pulmonary valve replacement in patients with congenital heart disease?
Careful pre-interventional imaging using CMR, CT, and fusion imaging is essential for planning percutaneous pulmonary valve replacement in congenital heart disease patients.
Answers are grounded in this paper and cite their sources.
Noninvasive imaging may guide PPVR planning in variable RVOT; leaves open optimal modality and outcomes in prospective studies.
The majority of patients with congenital heart disease (CHD) who have undergone open heart surgery during childhood are possible candidates for additional transcatheter or surgical interventions. One fifth of these conditions usually involve the right ventricular outflow tract (RVOT). Percutaneous pulmonary valve replacement (PPVR) has been widely established as an alternative, less invasive option to surgical pulmonary valve replacement (SPVR). The variability of RVOT anatomy and size, the relative course of the coronary arteries, and the anatomy of the pulmonary artery branches are factors that determine the success of the intervention and the complication rates. Careful and reliable pre-interventional imaging warrants the selection of suitable candidates and minimizes the risk of complications. 2D and 3D fluoroscopy have been extensively used during pre- and peri-interventional assessment. Established imaging techniques such as cardiovascular magnetic resonance (CMR) and computed tomography (CT) and newer techniques such as fusion imaging have proved to be efficient and reliable tools during pre-procedural planning in patients assessed for PPVR.
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Boutsikou et al. (2022) conducted a review in Congenital heart disease requiring percutaneous pulmonary valve replacement. Noninvasive imaging (CMR, CT, fusion imaging) was evaluated. Noninvasive imaging techniques, including CMR, CT, and fusion imaging, are efficient and reliable tools for pre-procedural planning in patients assessed for percutaneous pulmonary valve replacement.
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