title: Initial experience with live three-dimensional image overlay for ductal stenting in hypoplastic left heart syndrome.
abstract: OBJECTIVE
  Precise visualisation of ductal morphology and adjacent vessels is crucial for accurate stent choice and placement during hybrid palliation of hypoplastic left heart syndrome (HLHS). We aimed to describe our initial experience with live three-dimensional reconstruction overlay derived from rotational angiography (RA) for ductal stenting in HLHS.
  
  
  RESULTS
  We carried out a retrospective review of ductal stenting in 18 newborns with HLHS, including six patients with 3D reconstruction overlay used to guide the intervention. The median age at the intervention was 20 days (range 13-31 days) and the median weight was 3.25 kg (range 3-4 kg). Eleven RA runs were performed, pre and post stent implantation in five patients and before the intervention in one patient. 3D reconstructions from all RA runs had sufficient image quality to allow stent placement without additional contrast injections. Comparison with 2D angiography-guided ductal stenting showed similar contrast usage, with the 2D angiography patients receiving a higher radiation dose.
  
  
  CONCLUSIONS
  Three-dimensional rotational angiography provides accurate visualisation of the ductal morphology and nearby structures. Three-dimensional reconstruction overlay with clear landing points enabled precise stent implantation with no additional contrast injections and lower radiation doses than conventional angiography in our patients.
authors.affiliation: Department of Cardiology, Polish Mother's Memorial Hospital, Research Institute, Lodz, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Goreczny
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Morgan
authors.forename: Pawel
authors.initials: P
authors.lastname: Dryzek
authors.forename: Jadwiga A
authors.initials: JA
authors.lastname: Moll
authors.forename: Tomasz
authors.initials: T
authors.lastname: Moszura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D006328:Cardiac Catheterization / Q000009:adverse effects; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult