title: The use of three-dimensional rotational angiography to assess the pulmonary circulation following cavo-pulmonary connection in patients with single ventricle.
abstract: BACKGROUND
  Bi-plane angiography is the gold standard for imaging the pulmonary arteries (PAs) after cavo-pulmonary connection (CPC). Three-dimensional rotational angiography (3DRA) is emerging technology that we hypothesized may enhance diagnostic capabilities in this patient group.
  
  
  METHODS
  Retrospective review of patients who underwent 3DRA to assess the PAs after CPC. 3DRA images were examined for diagnostic quality and compared, both qualitatively and quantitatively with corresponding 2D images.
  
  
  RESULTS
  Between 1/2010 and 12/2010, 37 3DRAs were obtained in 32 pts with prior CPC. Median age and weight were 4.3 years (0.3-19) and 15.7 kg (4.3-114). Previous surgery included: bi-directional Glenn (16), bilateral bi-directional Glenn (2), and Fontan (14). Thirty-three (89%) acquisitions in 28 pts were of diagnostic quality. In 19/28 pts (68%) 3DRA provided significant additional information pertaining to 22 lesions when compared with bi-plane angiography. These included delineating the mechanism of PA stenosis in 13 (aortic compression: 7, PA torsion: 6), demonstrating a discrete PA stenosis not seen or under appreciated on corresponding 2D images in 9. This additional information led to the performance of 9 interventions (stent implantation 8, angioplasty 1). Corresponding 2D and 3DRA images of the right and left PA were compared using quantitative analysis with a correlation coefficient of 0.94 (P < 0.001) and 0.97 (P < 0.001), for the right and left PAs respectively.
  
  
  CONCLUSIONS
  3DRA can be performed safely and effectively following CPC and may be more sensitive in diagnosing PA stenoses than 2D angiography. Quantitative measurements of PA diameter using 3DRA correlates well with 2D angiography.
authors.affiliation: Miami Children's Hospital, Ambulatory Care Building, Miami, Florida 33155, USA. darren.berman@mch.com
authors.forename: Darren P
authors.initials: DP
authors.lastname: Berman
authors.forename: Danyal M
authors.initials: DM
authors.lastname: Khan
authors.forename: Yunin
authors.initials: Y
authors.lastname: Gutierrez
authors.forename: Evan M
authors.initials: EM
authors.lastname: Zahn
mesh_terms: D000293:Adolescent; D000792:Angiography / Q000379:methods*; D017130:Angioplasty / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D018610:Heart Bypass, Right / Q000009:adverse effects; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult