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DOI: 10.1055/s-0033-1354534
Value of 3D Rotational Angiography and MRI-Based Cardiac Mapping for Complex Interventional Procedures
Introduction: Complex interventional procedures may be indicated in children or adult with congenital heart disease. Visualization and anatomical characterization are needed to achieve the optimal therapeutical goal.
Method: Proof of principal for the impact of 3DRA and 3D MRI mapping in selected patients with different congenital heart disease. MRI data (DICOM) were selected and imported before the catheterization procedure, 3DRA was performed using the Phillips Allura Xper and “Heart Navigator.”
Results: We report our initial experiences from more than 20 different patients with mapping of complex anatomical structures during or before stent implantation for coarctation, pulmonary branch stenosis, or pulmonary valve replacement. With the use of 3DRA and MRI mapping, we were able to improve the adjustment and planning of interventional procedure. Additional benefits were the possibility of 3D measurement (e.g., balloon diameter) in the area of interest without additional angiographic projections. In advance simulation of the optimal projection for the interventional procedure according to the MRI data are also possible. These may reduce overall X-ray exposure for the patients and examiner.
Perspective: 3DRA and mapping of fluoroscopy with 3D-MRI data show a great opportunity for improved guidance of complex interventions in patients with congenital heart disease. It is worth to further clinically evaluate this tool in the field of interventional therapy of congenital heart disease.