Imaging of congenital heart disease in adults.

Eur Heart J. 2015 Sep 29. pii: ehv519. [Epub ahead of print]

Imaging of congenital heart disease in adults.

Babu-Narayan SV1Giannakoulas G2Valente AM3Li W1Gatzoulis MA4.


Comment by Michiel Winter

Cardiovascular Magnetic Resonance Imaging plays an important role in the assessment and follow-up of patients with congenital heart disease. Free-breathing protocols are increasing performed to assess cardiac anatomy in children, and patients having difficulty to follow breathing instructions. Predominantly, respiratory gating is used to obtain high quality images. As an alternative, a motion correction algorithm has been developed to produce 3D CMR images, which is based on cardiac self-navigation. The current study describes 138 unselected patients with congenital heart disease ≥2 years old (23.4 +/- 12.2 yrs) who underwent CMR using the cardiac motion correction algorithm to assess 1. image quality, 2. accuracy and reproducibility of morphological analysis, 3. coronary artery visualization, and 4. great vessel diameters. Image quality was sufficient for adequate image analysis in 90% of cases, and was considered good to excellent in 70% of cases. Correct morphological analysis was achieved in >93% of cases, and the proximal course of the coronary arteries could be visualized 90% of cases. Reproducibility of great vessel diameters was high. Image quality was predominantly influenced by high heart rate, low ejection fraction and younger age. This self-navigated 3D CMR seems a valuable expansion for cardiac assessment in patients with congenital heart disease, especially in those with difficulty to follow breathing instructions.