Purpose
BACKGROUND
Coronary arteries obstruction is the main cause of
mortality and morbidity in patients who underwent
arterial switch for transposition of great arteries.
Long-term outcome of coronary transfer and its
consequences on myocardial perfusion is scarcely
known.
AIM
To evaluate feasibility of cardiac MRI to describe
coronary anatomy,
myocardial perfusion and
fibrosis after arterial switch operation
Methods and Materials
METHODS
110 patients (mean age 13.5 y) were included.
Twenty-five/110 had previously documented coronary
artery obstruction.
cMRI procotol included cine SSFP in
short axis,
two-chamber,
three and four chamber view,
and perfusion analysis before and after dipyridamole
infusion.
Anatomy was evaluated by 3D heart sequence
in 78 patients.
Finally,
late enhancement was evaluated
ten minutes after injection of contrast agent in 71
patients.
Results
RESULTS
Perfusion could always be evaluated in all patients.
One
perfusion defect was identified.
This patient had left coronary stenosis at coronarography.
Anatomical evaluation of proximal coronary
arteries was possible in 71/78 patients.
Finally,
we found
limited myocardial fibrosis in only two/71 patients who
had left coronary artery obstruction that had been
repaired.
Conclusion
CONCLUSION
cMRI is feasible and gives comprehensive information
on coronary artery anatomy and physiology after the
arterial switch operation.
Use of cMRI as a screening
tool for late coronary artery obstruction should be
further evaluated in a larger series of patients to
obtain information on its sensitivity and specificity.