Cardiovascular magnetic resonance catheterization derived pulmonary vascular resistance and medium-termoutcomes in congenital heart disease

J Cardiovasc Magn Reson. 2015 Apr 14;17:28. doi: 10.1186/s12968-015-0130-4.

Cardiovascular magnetic resonance catheterization derived pulmonary vascular resistance and medium-termoutcomes in congenital heart disease.

Pushparajah K1,2Tzifa A3Bell A4Wong JK5Hussain T6,7Valverde I8Bellsham-Revell HR9Greil G10,11Simpson JM12,13Schaeffter T14Razavi R15,16.

Comment: Elevated pulmonary vascular resistance (PVR) causes significant morbidity and mortality in children. Therefore, accurate assessment of pulmonary vascular resistance is crucial in clinical decision-making in patients in need of surgical septation in biventricular repair or palliation in functionally single ventricle. Invasive studies for direct measurement of pressures are still recommended. The current study assessed the accuracy of hybrid cardiovascular magnetic resonance (CMR) and fluoroscopic guided cardiac catheterizations (XMR) to evaluate PVR in patients with uni- or biventricular circulations. In total, 149 patients (median age 3.6 years; 13.8 kg)  underwent 167 CMR/XMR and were followed-up for 4.2 years. The study demonstrates that patients with L-R shunt lesions, and  PVR of up to 6 WU.m2 have good long-term outcomes following surgical repair. Mean radiation exposure was 0.72 mSv in CMR/XMR, which is much less than in conventional catheterization. In summary, CMR/XMR provides an accurate, and safe tool for risk stratification of patients with congenital heart disease being considered for interventions.