Cardiac Magnetic Resonance Imaging Prior to Bidirectional Cavopulmonary Connection in Hypoplastic Left Heart Syndrome

Jones, Bryn O.; Ditchfield, Michael R.; Cahoon, Glenn D.; Hardy, Pollyanna; d’Udekem, Yves; Brizard, Christian P.; Penny, Daniel J.; Cheung, Michael M.H.

doi:10.1016/j.hlc.2010.03.009

« Previous Next »Heart, Lung and Circulation
Volume 19, Issue 9 , Pages 535-540, September 2010

Cardiac Magnetic Resonance Imaging Prior to Bidirectional Cavopulmonary Connection in Hypoplastic Left Heart Syndrome

Bryn O. Jones, FRACP
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia
- Australian and New Zealand Children's Heart Research Centre, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Corresponding author at: Department of Cardiology, The Royal Children's Hospital, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia. Tel.: +61 3 93455713; fax: +61 3 93456001.
Michael R. Ditchfield, FRANZCR
- Department of Paediatrics, University of Melbourne, Australia
- Department of Medical Imaging, The Royal Children's Hospital, Australia
Glenn D. Cahoon, BAppSc, MMagResonTech
- Department of Medical Imaging, The Royal Children's Hospital, Australia
Pollyanna Hardy, MSc
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Australia
Yves d’Udekem, MD, PhD
- Australian and New Zealand Children's Heart Research Centre, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Cardiac Surgery Unit, The Royal Children's Hospital, Australia
Christian P. Brizard, MD
- Australian and New Zealand Children's Heart Research Centre, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Cardiac Surgery Unit, The Royal Children's Hospital, Australia
Daniel J. Penny, MD, PhD, FRACP
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia
- Australian and New Zealand Children's Heart Research Centre, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia
Michael M.H. Cheung, MBChB, MRCP
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia
- Australian and New Zealand Children's Heart Research Centre, Murdoch Children's Research Institute, Australia
- Department of Paediatrics, University of Melbourne, Australia

Received 22 October 2009; received in revised form 23 March 2010; accepted 26 March 2010.

Background

Recent evidence has suggested that haemodynamic information obtained from cardiac catheterisation is not essential in pre-operative assessment of children with hypoplastic left heart syndrome (HLHS) undergoing Bidirectional Cavopulmonary Connection (BCPC). Therefore our unit changed to cardiac Magnetic Resonance Imaging (MRI) in 2006. We aimed to compare peri-operative outcomes before and after this change.

Methods

Children with HLHS who underwent BCPC between 2004 and 2008 were identified. Data were collected regarding pre-operative findings and peri-operative outcomes.

Results

Forty patients were identified-catheterisation (n=21), MRI (n=19). Catheterisation patients were older at the time of BCPC (114.9±22.7 days vs. 95.4±11 days: p value 0.002), with no other differences in baseline data. Two patients required cardiopulmonary resuscitation during catheterisation; with no adverse events during MRI. Cardiopulmonary bypass time, ventilation time, inotrope score, and intensive care unit stay were similar. Length of hospital stay and oxygen saturations at discharge were also not significantly different.

Conclusions

We have demonstrated that post-operative course and outcomes are similar in patients with HLHS who had MRI or catheterisation as their pre-BCPC investigation. Additionally the complementary data provided by echocardiography and MRI safely provides sufficient anatomic and functional information with which to plan the BCPC.

Keywords: Heart defects, Congenital, Magnetic Resonance Imaging, Catheterisation, Echocardiography