Swipe om te navigeren naar een ander artikel
The online version of this article (doi: 10.1007/s12471-016-0899-2) contains supplementary material, which is available to authorized users.
Children with aortic coarctations (CoA) are increasingly percutaneously treated. Good visualisation of the CoA is mandatory and can be obtained with three-dimensional rotational angiography (3DRA). This study aims to compare the diagnostic and therapeutic additional value of 3DRA with conventional biplane angiography (CA) in children with a CoA.
Patients undergoing percutaneous treatment of CoA with balloon angioplasty (BA) or stent between 2003 and 2015, were retrospectively reviewed on success rate, complications, radiation and technical settings. Diagnostic quality of CA and 3DRA and additional value of 3DRA were scored.
In total, 134 patients underwent 183 catheterisations, 121 CA and 62 3DRA-guided. Median age was 0.52 years in the BA group and 11.19 years in the stent group. 3DRA was superior to CA in displaying the left ventricle (p = 0.008), ascending aorta (p < 0.001), aortic arch (p = 0.005) and coronary arteries (p < 0.001). In the BA group, 3DRA had a significantly higher success rate than CA (100.0 % versus 68.9 %, p = 0.016). All stent interventions were successful. Complication rates did not differ significantly. The median total dose area product did not significantly differ between CA and 3DRA in the BA (27.88 μGym2/kg versus 15.81 μGym2/kg, p = 0.275) or stent group (37.34 μGym2/kg versus 45.24 μGym2/kg, p = 0.090). 3DRA was of additional value in 96.8 % of the interventions.
3DRA is superior to CA in diagnostic quality and not associated with increased radiation exposure. It provides high additional value in guiding CoA related interventions.
Glatz AC, Zhu X, Gillespie MJ, Hanna BD, Rome JJ. Use of angiographic CT imaging in the cardiac catheterization laboratory for congenital heart disease. J Am Coll Cardiol Img. 2010;3:1149–57. CrossRef
Erbel R, Aboyans V, Boileau C, et al. ESC guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J. 2014;2014(35): 2873–926.
Bergersen L, Marshall A, Gauvreau K, et al. Adverse event rates in congenital cardiac catheterization – a multi-center experience. Catheter Cardiovasc Interv. 2010;75:389–400. PubMed
Ammar RI. Balloon angioplasty for native aortic coarctation in children and infants younger than 12 months: immediate and medium-term follow-up. J Invasive Cardiol. 2012;24:662–6. PubMed
Ghelani SJ, Glatz AC, David S, et al. Radiation Dose Benchmarks During Cardiac Catheterization for Congenital Heart Disease in the United States. J Am Coll Cardiol Intv. 2014;7:1060–9. CrossRef
- Three-dimensional rotational angiography in children with an aortic coarctation
N. L. P. Starmans
G. J. Krings
M. M. C. Molenschot
F. van der Stelt
J. M. P. J. Breur
- Bohn Stafleu van Loghum