Akanksha N Thakkar1, Ponraj Chinnadurai, C Huie Lin. 1. aHouston Methodist Hospital, Houston, Texas bSiemens Medical Solutions, Hoffman Estates, Illinois cHouston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
Abstract
PURPOSE OF REVIEW: To provide an overview of current recommendations and techniques used to image coarctations of the aorta. RECENT FINDINGS: Imaging of coarctation of the aorta in adults is moving away from conventional techniques such as echocardiography and invasive angiography. Echocardiography may assist in making the diagnosis but is limited in its ability to quantify the severity of coarctations. Current guidelines recommend that every patient with a coarctation must undergo a computed tomography (CT) or MRI scan for accurate delineation of morphology. MRIs provide important hemodynamic data and this is rapidly evolving to include techniques such as 4D flow cardiac MRI which can provide time-resolved data; research on using MRIs in the interventional suite is underway. CT is important for surveillance and provides detailed information about repair-site anatomy. Additionally, the use of CT-based technology to guide transcatheter interventions may improve the safety and efficiency of angioplasty and stent deployment. SUMMARY: Although echocardiography is an important first line means to establish the diagnosis of aortic coarctations, CT and MRI-based techniques enable the provision of patient-specific management options, can guide transcatheter interventions and detect long-term post-intervention complications.
PURPOSE OF REVIEW: To provide an overview of current recommendations and techniques used to image coarctations of the aorta. RECENT FINDINGS: Imaging of coarctation of the aorta in adults is moving away from conventional techniques such as echocardiography and invasive angiography. Echocardiography may assist in making the diagnosis but is limited in its ability to quantify the severity of coarctations. Current guidelines recommend that every patient with a coarctation must undergo a computed tomography (CT) or MRI scan for accurate delineation of morphology. MRIs provide important hemodynamic data and this is rapidly evolving to include techniques such as 4D flow cardiac MRI which can provide time-resolved data; research on using MRIs in the interventional suite is underway. CT is important for surveillance and provides detailed information about repair-site anatomy. Additionally, the use of CT-based technology to guide transcatheter interventions may improve the safety and efficiency of angioplasty and stent deployment. SUMMARY: Although echocardiography is an important first line means to establish the diagnosis of aortic coarctations, CT and MRI-based techniques enable the provision of patient-specific management options, can guide transcatheter interventions and detect long-term post-intervention complications.
Authors: Djamila Abjigitova; Mostafa M Mokhles; Maarten Witsenburg; Pieter C van de Woestijne; Jos A Bekkers; Ad J J C Bogers Journal: Eur J Cardiothorac Surg Date: 2019-12-01 Impact factor: 4.191