Cardiac Magnetic Resonance Imaging to Determine Single Ventricle Function in a Pediatric Population is Feasible in a Large Trial Setting: Experience from the Single Ventricle Reconstruction Trial Longitudinal Follow up

Authors

Jon Detterich
Michael D Taylor
Timothy C Slesnick
Michael DiLorenzo
Anthony Hlavacek
Christopher Z Lam
Shagun Sachdeva
Sean M Lang
M Jay Campbell
Jennifer Gerardin
Kevin K Whitehead
Rahul H Rathod
Mark Cartoski
Shaji Menon
Felicia Trachtenberg
Russell Gongwer
Jane Newburger
Caren Goldberg
Adam L Dorfman
the Pediatric Heart Network Investigators

Publication Date

10-1-2023

Journal

Pediatric Cardiology

DOI

10.1007/s00246-023-03216-8

PMID

37405456

PMCID

PMC10435402

PubMedCentral® Posted Date

7-5-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Child, Follow-Up Studies, Treatment Outcome, Prospective Studies, Norwood Procedures, Pulmonary Artery, Heart Ventricles, Hypoplastic Left Heart Syndrome, Univentricular Heart, Magnetic Resonance Imaging, Magnetic Resonance Imaging, Cine, Cardiac Magenetic Resonance Imaging, Fontan Circulation, Pediatrics, Clinical Trial, Outcomes Research

Abstract

The Single Ventricle Reconstruction (SVR) Trial was a randomized prospective trial designed to determine survival advantage of the modified Blalock-Taussig-Thomas shunt (BTTS) vs the right ventricle to pulmonary artery conduit (RVPAS) for patients with hypoplastic left heart syndrome. The primary aim of the long-term follow-up (SVRIII) was to determine the impact of shunt type on RV function. In this work, we describe the use of CMR in a large cohort follow up from the SVR Trial as a focused study of single ventricle function. The SVRIII protocol included short axis steady-state free precession imaging to assess single ventricle systolic function and flow quantification. There were 313 eligible SVRIII participants and 237 enrolled, ages ranging from 10 to 12.5 years. 177/237 (75%) participants underwent CMR. The most common reasons for not undergoing CMR exam were requirement for anesthesia (n = 14) or ICD/pacemaker (n = 11). A total of 168/177 (94%) CMR studies were diagnostic for RVEF. Median exam time was 54 [IQR 40-74] minutes, cine function exam time 20 [IQR 14-27] minutes, and flow quantification time 18 [IQR 12-25] minutes. There were 69/177 (39%) studies noted to have intra-thoracic artifacts, most common being susceptibility artifact from intra-thoracic metal. Not all artifacts resulted in non-diagnostic exams. These data describe the use and limitations of CMR for the assessment of cardiac function in a prospective trial setting in a grade-school-aged pediatric population with congenital heart disease. Many of the limitations are expected to decrease with the continued advancement of CMR technology.