title: Magnetic resonance angiography in paced complex heterotaxy syndrome with Fontan conduit obstruction and venovenous collateral decompression.
abstract: Imaging of complex congenital heart diseases (CHDs) in children is challenging. This article reviews the complementary role of high temporal and high spatial resolution magnetic resonance (MR) angiographic imaging techniques in evaluation of a patient with complex congenital cardiovascular disease and related postsurgical complications. A 4-year-old female patient with complex CHD and multiple previous palliative surgical procedures underwent MR angiography to evaluate the cause of refractory hypoxia. High-resolution MR angiography demonstrated the complex postsurgical cardiovascular anatomy and also assisted in the evaluation of cavopulmonary shunt patency and secondary venovenous shunt formation. Time-resolved MR angiography evaluated pulmonary perfusion and demonstrated a significant pulmonary arteriovenous malformation. This information guided physicians in planning further managements, which resulted in a satisfactory clinical outcome.
authors.affiliation: Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Saeed
authors.initials: S
authors.lastname: Mirsadraee
authors.forename: Gary M
authors.initials: GM
authors.lastname: Satou
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Renella
authors.forename: Aijaz
authors.initials: A
authors.lastname: Hashmi
authors.forename: Hillel
authors.initials: H
authors.lastname: Laks
authors.forename: John Paul
authors.initials: JP
authors.lastname: Finn
mesh_terms: D000015:Abnormalities, Multiple; D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D002675:Child, Preschool; D003097:Collateral Circulation; D003287:Contrast Media; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D059446:Heterotaxy Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008536:Meglumine / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D010166:Palliative Care; D010690:Phlebography; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine