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Identification of coronary artery anatomy on dual-source cardiac computed tomography before arterial switch operation in newborns and young infants: comparison with transthoracic echocardiography

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Abstract

Background

Considering inherent limitations of transthoracic echocardiography, the diagnostic accuracy of cardiac CT in identifying coronary artery anatomy before arterial switch operation needs to be investigated with recently improved coronary artery visibility using electrocardiogram (ECG)-synchronized dual-source CT.

Objective

To compare diagnostic accuracy between cardiac CT using a dual-source scanner and transthoracic echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants.

Materials and methods

The study included 101 infants (median age 4 days, range 0 days to 10 months; M:F=78:23) who underwent ECG-synchronized cardiac dual-source CT and transthoracic echocardiography before arterial switch operation between July 2011 and December 2016. We evaluated and classified coronary artery anatomy on cardiac CT and transthoracic echocardiography. With the surgical findings as the reference standard, we compared the diagnostic accuracy for identifying coronary artery anatomy between cardiac CT and transthoracic echocardiography.

Results

The most common coronary artery pattern was the usual pattern (left coronary artery from sinus 1 and right coronary artery from sinus 2; 64.4%, 65/101), followed by a single coronary artery from sinus 2 and a conal branch from sinus 1 (7.9%, 8/101), the inverted pattern (5.9%, 6/101), the right coronary artery and left anterior descending artery from sinus 1 and the left circumflex artery from sinus 2 (5.9%, 6/101), and others. In 96 infants with surgically proven coronary artery anatomy, the diagnostic accuracy of cardiac CT was significantly higher than that of transthoracic echocardiography (91.7%, 88/96 vs. 54.2%, 52/96; P<0.0001).

Conclusion

Diagnostic accuracy of cardiac CT is significantly higher than that of echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants.

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References

  1. Baslaim GM (2006) Is preoperative delineation of coronary artery pattern a prerequisite for arterial switch operation? J Card Surg 21:465–470

    Article  PubMed  Google Scholar 

  2. Angeli E, Formigari R, Pace Napoleone C et al (2010) Long-term coronary artery outcome after arterial switch operation for transposition of the great arteries. Eur J Cardiothorac Surg 38:714–720

    Article  PubMed  Google Scholar 

  3. Rudra HS, Mavroudis C, Backer CL et al (2011) The arterial switch operation: 25-year experience with 258 patients. Ann Thorac Surg 92:1742–1746

    Article  PubMed  Google Scholar 

  4. Yacoub MH, Radley-Smith R (1978) Anatomy of the coronary arteries in transposition of the great arteries and methods for their transfer in anatomical correction. Thorax 33:418–424

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Planché C, Bruniaux J, Lacour-Gayet F et al (1988) Switch operation for transposition of the great arteries in neonates: a study of 120 patients. J Thorac Cardiovasc Surg 96:354–363

    PubMed  Google Scholar 

  6. Karl TR, Cochrane A, Brizard CP (1997) Arterial switch operation. Surgical solutions to complex problems. Tex Heart Inst J 24:322–333

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Suzuki T (2009) Modification of the arterial switch operation for transposition of the great arteries with complex coronary artery patterns. Gen Thorac Cardiovasc Surg 57:281–292

    Article  PubMed  Google Scholar 

  8. Pasquini L, Sanders SP, Parness IA et al (1994) Coronary echocardiography in 406 patients with d-loop transposition of the great arteries. J Am Coll Cardiol 24:763–768

    Article  CAS  PubMed  Google Scholar 

  9. Gremmels DB, Tacy TA, Brook MM et al (2004) Accuracy of coronary artery anatomy using two-dimensional echocardiography in d-transposition of great arteries using a two-reviewer method. J Am Soc Echocardiogr 17:454–460

    Article  PubMed  Google Scholar 

  10. Goo HW, Park IS, Ko JK et al (2005) Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease. Pediatr Radiol 35:792–798

    Article  PubMed  Google Scholar 

  11. Tsai IC, Lee T, Chen MC et al (2007) Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique. Pediatr Radiol 37:818–825

    Article  PubMed  Google Scholar 

  12. Goo HW, Seo DM, Yun TJ et al (2009) Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings. Pediatr Radiol 39:265–273

    Article  PubMed  Google Scholar 

  13. Ben Saad M, Rohnean A, Sigal-Cinqualbre A et al (2009) Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease. Pediatr Radiol 39:668–676

    Article  PubMed  Google Scholar 

  14. Goo HW (2010) State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol 11:4–18

    Article  PubMed  Google Scholar 

  15. Goo HW, Yang DH (2010) Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan. Pediatr Radiol 40:1670–1680

    Article  PubMed  Google Scholar 

  16. Goo HW (2015) Coronary artery imaging in children. Korean J Radiol 16:239–250

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chen SJ, Lin MT, Lee WJ et al (2007) Coronary artery anatomy in children with congenital heart disease by computed tomography. Int J Cardiol 120:363–370

    Article  PubMed  Google Scholar 

  18. Goo HW, Allmendinger T (2017) Combined ECG- and respiratory-triggered CT of the lung to reduce respiratory misregistration artifacts between imaging slabs in free-breathing children: initial experience. Korean J Radiol 18:860–866

    Article  PubMed  PubMed Central  Google Scholar 

  19. Goo HW (2011) Individualized volume CT dose index determined by cross-sectional area and mean density of the body to achieve uniform image noise of contrast-enhanced pediatric chest CT obtained at variable kV levels and with combined tube current modulation. Pediatr Radiol 41:839–847

    Article  PubMed  Google Scholar 

  20. Freire G, Miller MS (2015) Echocardiographic evaluation of coronary arteries in congenital heart disease. Cardiol Young 25:1504–1511

    Article  PubMed  Google Scholar 

  21. Lacour-Gayet F (2012) Complexity stratification of the arterial switch operation: a second learning curve. Cardiol Young 22:739–744

    Article  PubMed  Google Scholar 

  22. Bang JH, Park JJ, Goo HW (2017) Evaluation of commissural malalignment of aortic-pulmonary sinus using cardiac CT for arterial switch operation: comparison with transthoracic echocardiography. Pediatr Radiol 47:556–564

    Article  PubMed  Google Scholar 

  23. Goo HW (2011) Cardiac MDCT in children: CT technology overview and interpretation. Radiol Clin N Am 49:997–1010

    Article  PubMed  Google Scholar 

  24. Goo HW (2004) Evaluation of the airways in patients with congenital heart disease using multislice CT. J Korean Pediatr Cardiol Soc 8:37–43

    Google Scholar 

  25. Malik A, Hellinger JC, Servaes S et al (2017) Prevalence of non-cardiovascular findings on CT angiography in children with congenital heart disease. Pediatr Radiol 47:267–279

    Article  PubMed  Google Scholar 

  26. Kim JW, Goo HW (2013) Coronary artery abnormalities in Kawasaki disease: comparision between CT and MR coronary angiography. Acta Radiol 54:156–163

    Article  PubMed  Google Scholar 

  27. Tangcharoen T, Bell A, Hegde S et al (2011) Detection of coronary artery anomalies in infants and young children with congenital heart disease by using MR imaging. Radiology 259:240–247

    Article  PubMed  Google Scholar 

  28. Hussain T, Mathur S, Peel SA et al (2015) Coronary artery size and origin imaging in children: a comparative study of MRI and trans-thoracic echocardiography. BMC Med Imaging 15:48

    Article  PubMed  PubMed Central  Google Scholar 

  29. Fricke TA, Bulstra AE, Naimo PS et al (2016) Excellent long-term outcomes of the arterial switch operation in patients with intramural coronary arteries. Ann Thorac Surg 101:725–729

    Article  PubMed  Google Scholar 

  30. Ou P, Celermajer DS, Marini D et al (2008) Safety and accuracy of 64-slice computed tomography coronary angiography in children after the arterial switch operation for transposition of the great arteries. JACC Cardiovasc Imaging 1:331–339

    Article  PubMed  Google Scholar 

  31. Ou P, Khraiche D, Celermajer DS et al (2013) Mechanisms of coronary complications after the arterial switch for transposition of the great arteries. J Thorac Cardiovasc Surg 145:1263–1269

    Article  PubMed  Google Scholar 

  32. Anderson BR, Ciarleglio AJ, Hayes DA et al (2014) Earlier arterial switch operation improves outcomes and reduces costs for neonates with transposition of the great arteries. J Am Coll Cardiol 63:481–487

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Hyun Woo Goo

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Correspondence to Hyun Woo Goo.

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Goo, H.W. Identification of coronary artery anatomy on dual-source cardiac computed tomography before arterial switch operation in newborns and young infants: comparison with transthoracic echocardiography. Pediatr Radiol 48, 176–185 (2018). https://doi.org/10.1007/s00247-017-4004-9

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  • DOI: https://doi.org/10.1007/s00247-017-4004-9

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