Infants with one functional cardiac ventricle often undergo the Norwood procedure which seeks to create unobstructed outflow from the single ventricle to aorta using a complex aortic arch reconstruction. The distal region of the patch used to fashion the neo-aorta terminates near the aortic isthmus, and represents an area of extensive challenge and manipulation for cardiothoracic surgeons. Re-coarctation in this region is common after the Norwood procedure and may be linked with longer-term morbidity and mortality. Echocardiography (TTE) is the primary means of surveillance of the aortic isthmus, though measurements are often difficult due to poor acoustic windows and lack of patient cooperation. To date, there have been no studies that assess how accurately TTE measures the aortic isthmus relative to a computed tomography (CT) derived gold standard. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Ehrmann Daniel, Dimaria Michael, Fonseca Brian, Younoszai Adel, Browne Lorna

Keywords: Congenital Heart Disease, Single ventricle, Aortic Isthmus, Norwood, Coarctation

Infants with one functional cardiac ventricle undergo operations that yield unobstructed systemic outflow and a controlled source of pulmonary blood flow, often starting with the Norwood operation with Blalock-Taussig (BT) shunt. Infants with shunt dependent pulmonary blood flow are at risk for developing proximal pulmonary artery (PA) stenoses, which may result in morbidity and mortality. Echocardiography (TTE) is the primary means of surveillance for PA narrowing, but is limited by acoustic windows, operator experience and patient cooperation. Computed tomography (CT) offers high spatial resolution, rapid acquisition and relatively low radiation exposure. To date, there have been no studies comparing TTE and CT-derived measurements of the proximal PA anatomy in this high-risk population. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Ehrmann Daniel, Browne Lorna, Fonseca Brian, Younoszai Adel, Dimaria Michael

Keywords: Congenital Heart Disease, Single ventricle, Pulmonary Artery, CT, Echocardiography

4D flow MRI with full coverage of the heart and proximal vessels is a powerful tool to understand hemodynamic pathology arising from congenital heart disease (CHD) and subsequent surgery; however, scan times often exceed 10 minutes thereby limiting widespread adoption in pediatrics. Decreasing scan time using compressed-SENSE (CS), a combination of conventional parallel imaging (SENSE) and randomized spatial undersampling, shows promise over SENSE alone. However, both the feasibility and its effect on accurate flow quantification in pediatrics has not been evaluated. This study investigated the feasibility of CS for pediatric 4D flow MRI to quantify flow indices used in risk stratification of CHD such as coarctation or pulmonary regurgitation, in comparison with SENSE. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Fujiwara Takashi, Browne Lorna, Malone Ladonna, Lu Quin, Fonseca Brian, Dimaria Michael, Barker Alex

Keywords: 4D flow, Compressed SENSE, Congenital heart disease

<b>Introduction</b>: Conventional pediatric MRI acquisitions of a short axis (SA) stack for ventricular volumes typically requires one breath-hold per slice, resulting in multiple coordinated breath-holds under anesthesia to acquire the entire stack. Here, we aim to validate a compressed sensing approach to reduce breath-holding during SA balanced steady state free precession (bSSFP) cine imaging. Equivalency is tested via qualitative image scoring and global volumes compared to conventional bSSFP cine imaging. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Naresh Nivedita, Browne Lorna, Barker Alex, Malone Ladonna, Fujiwara Takashi, Hulseberg-dwyer Emma, Mcgee Janet, Lu Quin, Twite Mark, Dimaria Michael, Fonseca Brian

Keywords: Compressed Sensing, Cardiac Function, Anesthesia