Four dimensional pulmonary flow evaluation in adolescent patients after surgical and percutaneous pulmonary valve implantation

Background In patients with congenital heart defects, restoration of the connection between the right ventricle (RV) and the pulmonary artery (PA) by surgical or percutaneous valved conduit implantation is a common procedure. Flow characteristics in such conduits are complex, therefore the aim of this study was demonstrating the potential application of 4D MRI flow for the comprehensive assessment of pulmonary flow patterns after surgical and percutaneous RV-PA valved conduit implantation. Methods Fifteen patients after surgical RV-PA valved conduit implantation (15.8 ± 1.7 years), 15 patients after percutaneous implantation (17.2 ± 2.0 years), and 15 healthy volunteers (as a control group) (16.5 ± 1.5 years) were included. All subjects underwent a comprehensive cardiac MRI protocol. Analysis focused on evaluation of the RV systolic function and RV mass, the presence of vertical flow patterns, pulmonary flow eccentricity pulmonary artery diameters, and wall shear rate (WSR) assessment. (Figure 1)