Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings
Cardiac catheterization is the gold-standard modality for investigation of cardiovascular morphology before bidirectional cavopulmonary connection, but requires general anaesthesia and is associated with procedural risk. To assess the diagnostic accuracy and safety of computed tomography in diagnosi...
Gespeichert in:
| Veröffentlicht in: | Archives of cardiovascular diseases 2019-01, Vol.112 (1), p.12-21 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 21 |
|---|---|
| container_issue | 1 |
| container_start_page | 12 |
| container_title | Archives of cardiovascular diseases |
| container_volume | 112 |
| creator | Krupickova, Sylvia Vazquez-Garcia, Laura Obeidat, Monther Banya, Winston DiSalvo, Giovanni Ghez, Olivier Michielon, Guido Castellano, Isabel Rubens, Michael Semple, Thomas Nicol, Edward Slavik, Zdenek Rigby, Michael L. Fraisse, Alain |
| description | Cardiac catheterization is the gold-standard modality for investigation of cardiovascular morphology before bidirectional cavopulmonary connection, but requires general anaesthesia and is associated with procedural risk.
To assess the diagnostic accuracy and safety of computed tomography in diagnosing great vessel stenosis/hypoplasia compared with cardiac catheterization and surgical findings.
Twenty-seven patients (10 after Norwood stage I) underwent computed tomography before surgery between January 2010 and June 2016; 16 of these patients also underwent cardiac catheterization. Proximal and distal pulmonary artery, aortic isthmus and descending aorta measurements, radiation dose and complications were compared via Bland-Altman analyses and correlation coefficients.
The accuracy of computed tomography in detecting stenosis/hypoplasia of either pulmonary artery was 96.1% compared with surgical findings. For absolute vessel measurements and Z-scores, there was high correlation between computed tomography and angiography at catheterization (r=0.98 for both) and a low mean bias (0.71mm and 0.48; respectively). The magnitude of intertechnique differences observed for individual patients was low (95% of the values ranged between −0.9 and 2.3mm and between −0.7 and 1.7, respectively). Four patients (25%) experienced minor complications from cardiac catheterization, whereas there were no complications from computed tomography. Patients tended to receive a higher radiation dose with cardiac catheterization than with computed tomography, even after exclusion of interventional catheterization procedures (median 2.5 mSv [interquartile range 1.3 to 3.4 mSv] versus median 1.3 mSv [interquartile range 0.9 to 2.6 mSv], respectively; P=0.13). All computed tomography scans were performed without sedation.
Computed tomography may replace cardiac catheterization in identification of great vessel stenosis/hypoplasia before bidirectional cavopulmonary connection when no intervention before surgery is required. Computed tomography carries lower morbidity, can be performed without sedation and may be associated with less radiation.
Le cathétérisme est l’examen de référence pour l’évaluation morphologique cardiovasculaire avant la dérivation cavopulmonaire bidirectionnelle supérieure, mais il nécessite une anesthésie générale et comporte des risques liés à la procédure.
Notre objectif était de comparer la performance diagnostique et la sécurité de la tomodensitométrie cardiaque |
| doi_str_mv | 10.1016/j.acvd.2018.04.006 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2076239555</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1875213618300925</els_id><sourcerecordid>2076239555</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-68e8a1d33e1de6ba48747824a09b728aaf807c8a5e31dc4c293dc9bd51c7c3bd3</originalsourceid><addsrcrecordid>eNp9kcmO1DAQhiMEYoaBF-CAfOTSwUsWN-IyarFJI3GBs1UpV7rdSuxgJz1q3pC3wk2GOXIqW_XVX8tfFK8FLwUXzbtjCXiypeRCl7wqOW-eFNdCt_VGCqmfPr5Vc1W8SOmYAdm2zfPiSnFeCd2o6-L3LeISAc8s9AzDOC0zWTaHMewjTIczc55ZmglnF_yF2UeCmZ0oJRpYmsmH5BILkR3OU5gGSA5YR32IxNIyUXQ51Tnr4ioBA0M4hWkZxvyJ59zT-zX1nu1yf4gu5U73bj5kMloHmON8yDNE9wv-jgHeZvG4d5jleuet8_v0snjWw5Do1UO8KX58-vh992Vz9-3z193t3QYrzudNo0mDsEqRsNR0UOm2arWsgG-7VmqAXvMWNdSkhMUK5VZZ3Ha2Ftii6qy6Kd6uulMMPxdKsxldQhoG8BSWZCRvG6m2dV1nVK4oxpBSpN5M0Y15ayO4uVhojuZioblYaHhlskO56M2D_tKNZB9L_nmWgQ8rQHnLk6NoEjrySOuRjQ3uf_p_APUFtMw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2076239555</pqid></control><display><type>article</type><title>Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Krupickova, Sylvia ; Vazquez-Garcia, Laura ; Obeidat, Monther ; Banya, Winston ; DiSalvo, Giovanni ; Ghez, Olivier ; Michielon, Guido ; Castellano, Isabel ; Rubens, Michael ; Semple, Thomas ; Nicol, Edward ; Slavik, Zdenek ; Rigby, Michael L. ; Fraisse, Alain</creator><creatorcontrib>Krupickova, Sylvia ; Vazquez-Garcia, Laura ; Obeidat, Monther ; Banya, Winston ; DiSalvo, Giovanni ; Ghez, Olivier ; Michielon, Guido ; Castellano, Isabel ; Rubens, Michael ; Semple, Thomas ; Nicol, Edward ; Slavik, Zdenek ; Rigby, Michael L. ; Fraisse, Alain</creatorcontrib><description>Cardiac catheterization is the gold-standard modality for investigation of cardiovascular morphology before bidirectional cavopulmonary connection, but requires general anaesthesia and is associated with procedural risk.
To assess the diagnostic accuracy and safety of computed tomography in diagnosing great vessel stenosis/hypoplasia compared with cardiac catheterization and surgical findings.
Twenty-seven patients (10 after Norwood stage I) underwent computed tomography before surgery between January 2010 and June 2016; 16 of these patients also underwent cardiac catheterization. Proximal and distal pulmonary artery, aortic isthmus and descending aorta measurements, radiation dose and complications were compared via Bland-Altman analyses and correlation coefficients.
The accuracy of computed tomography in detecting stenosis/hypoplasia of either pulmonary artery was 96.1% compared with surgical findings. For absolute vessel measurements and Z-scores, there was high correlation between computed tomography and angiography at catheterization (r=0.98 for both) and a low mean bias (0.71mm and 0.48; respectively). The magnitude of intertechnique differences observed for individual patients was low (95% of the values ranged between −0.9 and 2.3mm and between −0.7 and 1.7, respectively). Four patients (25%) experienced minor complications from cardiac catheterization, whereas there were no complications from computed tomography. Patients tended to receive a higher radiation dose with cardiac catheterization than with computed tomography, even after exclusion of interventional catheterization procedures (median 2.5 mSv [interquartile range 1.3 to 3.4 mSv] versus median 1.3 mSv [interquartile range 0.9 to 2.6 mSv], respectively; P=0.13). All computed tomography scans were performed without sedation.
Computed tomography may replace cardiac catheterization in identification of great vessel stenosis/hypoplasia before bidirectional cavopulmonary connection when no intervention before surgery is required. Computed tomography carries lower morbidity, can be performed without sedation and may be associated with less radiation.
Le cathétérisme est l’examen de référence pour l’évaluation morphologique cardiovasculaire avant la dérivation cavopulmonaire bidirectionnelle supérieure, mais il nécessite une anesthésie générale et comporte des risques liés à la procédure.
Notre objectif était de comparer la performance diagnostique et la sécurité de la tomodensitométrie cardiaque avec le cathétérisme et l’examen peropératoire pour le diagnostic des sténoses et/ou hypoplasies des gros vaisseaux en comparaison.
Vingt-sept patients (10 après une intervention de Norwood) ont eu une tomodensitométrie cardiaque avant la chirurgie entre janvier 2010 et juin 2016. Seize d’entre eux ont également eu un cathétérisme cardiaque. Les mesures proximales et distales des artères pulmonaires, de l’isthme aortique et de l’aorte descendante, ainsi que l’irradiation et les complications per procédurales ont été comparées entre les 2 investigations à l’aide des coefficients de Bland-Altman et de corrélation.
La précision de la tomodensitométrie pour la détection de sténoses/hypoplasies des artères pulmonaires était 96,1 % en comparaison avec l’évaluation peropératoire lors de la chirurgie. Pour les mesures des vaisseaux et les Z-scores, il y avait une excellente corrélation entre la tomodensitométrie et l’angiographie lors du cathétérisme (0,98 pour les 2), peu de biais (0,71mm vs 0,48, respectivement). La difference de magnitude observée entre les 2 techniques pour chaque individu est faible ainsi que reflètent les intervalles a 95 % des valeurs mesurées allant de −0,9 à 2,3mm et de −0,7 à 1,7, respectivement. Quatre patients ont souffert de complications mineures lors du cathétérisme alors qu’il n’y a eu aucune complication liée à la tomodensitométrie. Les patients ont eu tendance à recevoir une irradiation plus importante lors du cathétérisme que lors de la tomodensitométrie (médiane 2,5 mSv [IQR 1,3 à 3,4 mSv] vs 1,3 mSv [0,9 à 2,6 mSv], respectivement; P=0,13). Toutes les tomodensitométries ont été effectuées sans sédation.
La tomodensitométrie peut potentiellement remplacer le cathétérisme pour identifier les sténoses et/ou hypoplasies des gros vaisseaux avant la dérivation cavopulmonaire bidirectionnelle, à condition qu’il n’y ait pas besoin d’intervention. La tomodensitométrie a une morbidité moindre, ne nécessite pas de sédation et elle est moins irradiante.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2018.04.006</identifier><identifier>PMID: 30041863</identifier><language>eng</language><publisher>Netherlands: Elsevier Masson SAS</publisher><subject>Aorta - abnormalities ; Aorta - diagnostic imaging ; Aorta - physiopathology ; Aorta - surgery ; Bidirectional Glenn ; Cardiac Catheterization - adverse effects ; Computed tomography ; Computed Tomography Angiography - adverse effects ; Constriction, Pathologic ; Female ; Fontan Procedure ; Glenn bidirectionnel ; Heart Defects, Congenital - diagnostic imaging ; Heart Defects, Congenital - physiopathology ; Heart Defects, Congenital - surgery ; Hemodynamics ; Humans ; Male ; Predictive Value of Tests ; Pulmonary Artery - abnormalities ; Pulmonary Artery - diagnostic imaging ; Pulmonary Artery - physiopathology ; Pulmonary Artery - surgery ; Radiation Dosage ; Radiation Exposure - adverse effects ; Radiation Exposure - prevention & control ; Reproducibility of Results ; Retrospective Studies ; Risk Factors ; Scanner cardiaque ; Single ventricle ; Ventricule unique</subject><ispartof>Archives of cardiovascular diseases, 2019-01, Vol.112 (1), p.12-21</ispartof><rights>2018 Elsevier Masson SAS</rights><rights>Copyright © 2018 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-68e8a1d33e1de6ba48747824a09b728aaf807c8a5e31dc4c293dc9bd51c7c3bd3</citedby><cites>FETCH-LOGICAL-c400t-68e8a1d33e1de6ba48747824a09b728aaf807c8a5e31dc4c293dc9bd51c7c3bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1875213618300925$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30041863$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krupickova, Sylvia</creatorcontrib><creatorcontrib>Vazquez-Garcia, Laura</creatorcontrib><creatorcontrib>Obeidat, Monther</creatorcontrib><creatorcontrib>Banya, Winston</creatorcontrib><creatorcontrib>DiSalvo, Giovanni</creatorcontrib><creatorcontrib>Ghez, Olivier</creatorcontrib><creatorcontrib>Michielon, Guido</creatorcontrib><creatorcontrib>Castellano, Isabel</creatorcontrib><creatorcontrib>Rubens, Michael</creatorcontrib><creatorcontrib>Semple, Thomas</creatorcontrib><creatorcontrib>Nicol, Edward</creatorcontrib><creatorcontrib>Slavik, Zdenek</creatorcontrib><creatorcontrib>Rigby, Michael L.</creatorcontrib><creatorcontrib>Fraisse, Alain</creatorcontrib><title>Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>Cardiac catheterization is the gold-standard modality for investigation of cardiovascular morphology before bidirectional cavopulmonary connection, but requires general anaesthesia and is associated with procedural risk.
To assess the diagnostic accuracy and safety of computed tomography in diagnosing great vessel stenosis/hypoplasia compared with cardiac catheterization and surgical findings.
Twenty-seven patients (10 after Norwood stage I) underwent computed tomography before surgery between January 2010 and June 2016; 16 of these patients also underwent cardiac catheterization. Proximal and distal pulmonary artery, aortic isthmus and descending aorta measurements, radiation dose and complications were compared via Bland-Altman analyses and correlation coefficients.
The accuracy of computed tomography in detecting stenosis/hypoplasia of either pulmonary artery was 96.1% compared with surgical findings. For absolute vessel measurements and Z-scores, there was high correlation between computed tomography and angiography at catheterization (r=0.98 for both) and a low mean bias (0.71mm and 0.48; respectively). The magnitude of intertechnique differences observed for individual patients was low (95% of the values ranged between −0.9 and 2.3mm and between −0.7 and 1.7, respectively). Four patients (25%) experienced minor complications from cardiac catheterization, whereas there were no complications from computed tomography. Patients tended to receive a higher radiation dose with cardiac catheterization than with computed tomography, even after exclusion of interventional catheterization procedures (median 2.5 mSv [interquartile range 1.3 to 3.4 mSv] versus median 1.3 mSv [interquartile range 0.9 to 2.6 mSv], respectively; P=0.13). All computed tomography scans were performed without sedation.
Computed tomography may replace cardiac catheterization in identification of great vessel stenosis/hypoplasia before bidirectional cavopulmonary connection when no intervention before surgery is required. Computed tomography carries lower morbidity, can be performed without sedation and may be associated with less radiation.
Le cathétérisme est l’examen de référence pour l’évaluation morphologique cardiovasculaire avant la dérivation cavopulmonaire bidirectionnelle supérieure, mais il nécessite une anesthésie générale et comporte des risques liés à la procédure.
Notre objectif était de comparer la performance diagnostique et la sécurité de la tomodensitométrie cardiaque avec le cathétérisme et l’examen peropératoire pour le diagnostic des sténoses et/ou hypoplasies des gros vaisseaux en comparaison.
Vingt-sept patients (10 après une intervention de Norwood) ont eu une tomodensitométrie cardiaque avant la chirurgie entre janvier 2010 et juin 2016. Seize d’entre eux ont également eu un cathétérisme cardiaque. Les mesures proximales et distales des artères pulmonaires, de l’isthme aortique et de l’aorte descendante, ainsi que l’irradiation et les complications per procédurales ont été comparées entre les 2 investigations à l’aide des coefficients de Bland-Altman et de corrélation.
La précision de la tomodensitométrie pour la détection de sténoses/hypoplasies des artères pulmonaires était 96,1 % en comparaison avec l’évaluation peropératoire lors de la chirurgie. Pour les mesures des vaisseaux et les Z-scores, il y avait une excellente corrélation entre la tomodensitométrie et l’angiographie lors du cathétérisme (0,98 pour les 2), peu de biais (0,71mm vs 0,48, respectivement). La difference de magnitude observée entre les 2 techniques pour chaque individu est faible ainsi que reflètent les intervalles a 95 % des valeurs mesurées allant de −0,9 à 2,3mm et de −0,7 à 1,7, respectivement. Quatre patients ont souffert de complications mineures lors du cathétérisme alors qu’il n’y a eu aucune complication liée à la tomodensitométrie. Les patients ont eu tendance à recevoir une irradiation plus importante lors du cathétérisme que lors de la tomodensitométrie (médiane 2,5 mSv [IQR 1,3 à 3,4 mSv] vs 1,3 mSv [0,9 à 2,6 mSv], respectivement; P=0,13). Toutes les tomodensitométries ont été effectuées sans sédation.
La tomodensitométrie peut potentiellement remplacer le cathétérisme pour identifier les sténoses et/ou hypoplasies des gros vaisseaux avant la dérivation cavopulmonaire bidirectionnelle, à condition qu’il n’y ait pas besoin d’intervention. La tomodensitométrie a une morbidité moindre, ne nécessite pas de sédation et elle est moins irradiante.</description><subject>Aorta - abnormalities</subject><subject>Aorta - diagnostic imaging</subject><subject>Aorta - physiopathology</subject><subject>Aorta - surgery</subject><subject>Bidirectional Glenn</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography - adverse effects</subject><subject>Constriction, Pathologic</subject><subject>Female</subject><subject>Fontan Procedure</subject><subject>Glenn bidirectionnel</subject><subject>Heart Defects, Congenital - diagnostic imaging</subject><subject>Heart Defects, Congenital - physiopathology</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Predictive Value of Tests</subject><subject>Pulmonary Artery - abnormalities</subject><subject>Pulmonary Artery - diagnostic imaging</subject><subject>Pulmonary Artery - physiopathology</subject><subject>Pulmonary Artery - surgery</subject><subject>Radiation Dosage</subject><subject>Radiation Exposure - adverse effects</subject><subject>Radiation Exposure - prevention & control</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Scanner cardiaque</subject><subject>Single ventricle</subject><subject>Ventricule unique</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcmO1DAQhiMEYoaBF-CAfOTSwUsWN-IyarFJI3GBs1UpV7rdSuxgJz1q3pC3wk2GOXIqW_XVX8tfFK8FLwUXzbtjCXiypeRCl7wqOW-eFNdCt_VGCqmfPr5Vc1W8SOmYAdm2zfPiSnFeCd2o6-L3LeISAc8s9AzDOC0zWTaHMewjTIczc55ZmglnF_yF2UeCmZ0oJRpYmsmH5BILkR3OU5gGSA5YR32IxNIyUXQ51Tnr4ioBA0M4hWkZxvyJ59zT-zX1nu1yf4gu5U73bj5kMloHmON8yDNE9wv-jgHeZvG4d5jleuet8_v0snjWw5Do1UO8KX58-vh992Vz9-3z193t3QYrzudNo0mDsEqRsNR0UOm2arWsgG-7VmqAXvMWNdSkhMUK5VZZ3Ha2Ftii6qy6Kd6uulMMPxdKsxldQhoG8BSWZCRvG6m2dV1nVK4oxpBSpN5M0Y15ayO4uVhojuZioblYaHhlskO56M2D_tKNZB9L_nmWgQ8rQHnLk6NoEjrySOuRjQ3uf_p_APUFtMw</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Krupickova, Sylvia</creator><creator>Vazquez-Garcia, Laura</creator><creator>Obeidat, Monther</creator><creator>Banya, Winston</creator><creator>DiSalvo, Giovanni</creator><creator>Ghez, Olivier</creator><creator>Michielon, Guido</creator><creator>Castellano, Isabel</creator><creator>Rubens, Michael</creator><creator>Semple, Thomas</creator><creator>Nicol, Edward</creator><creator>Slavik, Zdenek</creator><creator>Rigby, Michael L.</creator><creator>Fraisse, Alain</creator><general>Elsevier Masson SAS</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings</title><author>Krupickova, Sylvia ; Vazquez-Garcia, Laura ; Obeidat, Monther ; Banya, Winston ; DiSalvo, Giovanni ; Ghez, Olivier ; Michielon, Guido ; Castellano, Isabel ; Rubens, Michael ; Semple, Thomas ; Nicol, Edward ; Slavik, Zdenek ; Rigby, Michael L. ; Fraisse, Alain</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-68e8a1d33e1de6ba48747824a09b728aaf807c8a5e31dc4c293dc9bd51c7c3bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aorta - abnormalities</topic><topic>Aorta - diagnostic imaging</topic><topic>Aorta - physiopathology</topic><topic>Aorta - surgery</topic><topic>Bidirectional Glenn</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Computed tomography</topic><topic>Computed Tomography Angiography - adverse effects</topic><topic>Constriction, Pathologic</topic><topic>Female</topic><topic>Fontan Procedure</topic><topic>Glenn bidirectionnel</topic><topic>Heart Defects, Congenital - diagnostic imaging</topic><topic>Heart Defects, Congenital - physiopathology</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Predictive Value of Tests</topic><topic>Pulmonary Artery - abnormalities</topic><topic>Pulmonary Artery - diagnostic imaging</topic><topic>Pulmonary Artery - physiopathology</topic><topic>Pulmonary Artery - surgery</topic><topic>Radiation Dosage</topic><topic>Radiation Exposure - adverse effects</topic><topic>Radiation Exposure - prevention & control</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Scanner cardiaque</topic><topic>Single ventricle</topic><topic>Ventricule unique</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krupickova, Sylvia</creatorcontrib><creatorcontrib>Vazquez-Garcia, Laura</creatorcontrib><creatorcontrib>Obeidat, Monther</creatorcontrib><creatorcontrib>Banya, Winston</creatorcontrib><creatorcontrib>DiSalvo, Giovanni</creatorcontrib><creatorcontrib>Ghez, Olivier</creatorcontrib><creatorcontrib>Michielon, Guido</creatorcontrib><creatorcontrib>Castellano, Isabel</creatorcontrib><creatorcontrib>Rubens, Michael</creatorcontrib><creatorcontrib>Semple, Thomas</creatorcontrib><creatorcontrib>Nicol, Edward</creatorcontrib><creatorcontrib>Slavik, Zdenek</creatorcontrib><creatorcontrib>Rigby, Michael L.</creatorcontrib><creatorcontrib>Fraisse, Alain</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krupickova, Sylvia</au><au>Vazquez-Garcia, Laura</au><au>Obeidat, Monther</au><au>Banya, Winston</au><au>DiSalvo, Giovanni</au><au>Ghez, Olivier</au><au>Michielon, Guido</au><au>Castellano, Isabel</au><au>Rubens, Michael</au><au>Semple, Thomas</au><au>Nicol, Edward</au><au>Slavik, Zdenek</au><au>Rigby, Michael L.</au><au>Fraisse, Alain</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2019-01</date><risdate>2019</risdate><volume>112</volume><issue>1</issue><spage>12</spage><epage>21</epage><pages>12-21</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>Cardiac catheterization is the gold-standard modality for investigation of cardiovascular morphology before bidirectional cavopulmonary connection, but requires general anaesthesia and is associated with procedural risk.
To assess the diagnostic accuracy and safety of computed tomography in diagnosing great vessel stenosis/hypoplasia compared with cardiac catheterization and surgical findings.
Twenty-seven patients (10 after Norwood stage I) underwent computed tomography before surgery between January 2010 and June 2016; 16 of these patients also underwent cardiac catheterization. Proximal and distal pulmonary artery, aortic isthmus and descending aorta measurements, radiation dose and complications were compared via Bland-Altman analyses and correlation coefficients.
The accuracy of computed tomography in detecting stenosis/hypoplasia of either pulmonary artery was 96.1% compared with surgical findings. For absolute vessel measurements and Z-scores, there was high correlation between computed tomography and angiography at catheterization (r=0.98 for both) and a low mean bias (0.71mm and 0.48; respectively). The magnitude of intertechnique differences observed for individual patients was low (95% of the values ranged between −0.9 and 2.3mm and between −0.7 and 1.7, respectively). Four patients (25%) experienced minor complications from cardiac catheterization, whereas there were no complications from computed tomography. Patients tended to receive a higher radiation dose with cardiac catheterization than with computed tomography, even after exclusion of interventional catheterization procedures (median 2.5 mSv [interquartile range 1.3 to 3.4 mSv] versus median 1.3 mSv [interquartile range 0.9 to 2.6 mSv], respectively; P=0.13). All computed tomography scans were performed without sedation.
Computed tomography may replace cardiac catheterization in identification of great vessel stenosis/hypoplasia before bidirectional cavopulmonary connection when no intervention before surgery is required. Computed tomography carries lower morbidity, can be performed without sedation and may be associated with less radiation.
Le cathétérisme est l’examen de référence pour l’évaluation morphologique cardiovasculaire avant la dérivation cavopulmonaire bidirectionnelle supérieure, mais il nécessite une anesthésie générale et comporte des risques liés à la procédure.
Notre objectif était de comparer la performance diagnostique et la sécurité de la tomodensitométrie cardiaque avec le cathétérisme et l’examen peropératoire pour le diagnostic des sténoses et/ou hypoplasies des gros vaisseaux en comparaison.
Vingt-sept patients (10 après une intervention de Norwood) ont eu une tomodensitométrie cardiaque avant la chirurgie entre janvier 2010 et juin 2016. Seize d’entre eux ont également eu un cathétérisme cardiaque. Les mesures proximales et distales des artères pulmonaires, de l’isthme aortique et de l’aorte descendante, ainsi que l’irradiation et les complications per procédurales ont été comparées entre les 2 investigations à l’aide des coefficients de Bland-Altman et de corrélation.
La précision de la tomodensitométrie pour la détection de sténoses/hypoplasies des artères pulmonaires était 96,1 % en comparaison avec l’évaluation peropératoire lors de la chirurgie. Pour les mesures des vaisseaux et les Z-scores, il y avait une excellente corrélation entre la tomodensitométrie et l’angiographie lors du cathétérisme (0,98 pour les 2), peu de biais (0,71mm vs 0,48, respectivement). La difference de magnitude observée entre les 2 techniques pour chaque individu est faible ainsi que reflètent les intervalles a 95 % des valeurs mesurées allant de −0,9 à 2,3mm et de −0,7 à 1,7, respectivement. Quatre patients ont souffert de complications mineures lors du cathétérisme alors qu’il n’y a eu aucune complication liée à la tomodensitométrie. Les patients ont eu tendance à recevoir une irradiation plus importante lors du cathétérisme que lors de la tomodensitométrie (médiane 2,5 mSv [IQR 1,3 à 3,4 mSv] vs 1,3 mSv [0,9 à 2,6 mSv], respectivement; P=0,13). Toutes les tomodensitométries ont été effectuées sans sédation.
La tomodensitométrie peut potentiellement remplacer le cathétérisme pour identifier les sténoses et/ou hypoplasies des gros vaisseaux avant la dérivation cavopulmonaire bidirectionnelle, à condition qu’il n’y ait pas besoin d’intervention. La tomodensitométrie a une morbidité moindre, ne nécessite pas de sédation et elle est moins irradiante.</abstract><cop>Netherlands</cop><pub>Elsevier Masson SAS</pub><pmid>30041863</pmid><doi>10.1016/j.acvd.2018.04.006</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1875-2136 |
| ispartof | Archives of cardiovascular diseases, 2019-01, Vol.112 (1), p.12-21 |
| issn | 1875-2136 1875-2128 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2076239555 |
| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Aorta - abnormalities Aorta - diagnostic imaging Aorta - physiopathology Aorta - surgery Bidirectional Glenn Cardiac Catheterization - adverse effects Computed tomography Computed Tomography Angiography - adverse effects Constriction, Pathologic Female Fontan Procedure Glenn bidirectionnel Heart Defects, Congenital - diagnostic imaging Heart Defects, Congenital - physiopathology Heart Defects, Congenital - surgery Hemodynamics Humans Male Predictive Value of Tests Pulmonary Artery - abnormalities Pulmonary Artery - diagnostic imaging Pulmonary Artery - physiopathology Pulmonary Artery - surgery Radiation Dosage Radiation Exposure - adverse effects Radiation Exposure - prevention & control Reproducibility of Results Retrospective Studies Risk Factors Scanner cardiaque Single ventricle Ventricule unique |
| title | Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: Comparison with cardiac catheterization and surgical findings |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T04%3A46%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Accuracy%20of%20computed%20tomography%20in%20detection%20of%20great%20vessel%20stenosis%20or%20hypoplasia%20before%20superior%20bidirectional%20cavopulmonary%20connection:%20Comparison%20with%20cardiac%20catheterization%20and%20surgical%20findings&rft.jtitle=Archives%20of%20cardiovascular%20diseases&rft.au=Krupickova,%20Sylvia&rft.date=2019-01&rft.volume=112&rft.issue=1&rft.spage=12&rft.epage=21&rft.pages=12-21&rft.issn=1875-2136&rft.eissn=1875-2128&rft_id=info:doi/10.1016/j.acvd.2018.04.006&rft_dat=%3Cproquest_cross%3E2076239555%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2076239555&rft_id=info:pmid/30041863&rft_els_id=S1875213618300925&rfr_iscdi=true |