Faculty Collaboration Database

Dual-Axis Rotational Angiography is Safe and Feasible to Detect Coronary Allograft Vasculopathy in Pediatric Heart Transplant Patients: A Single-Center Experience. Pediatr Cardiol 2016 Apr;37(4):740-5

Date

02/06/2016

Pubmed ID

26846123

DOI

10.1007/s00246-016-1344-4

Scopus ID

2-s2.0-84957589365 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

Coronary allograft vasculopathy (CAV) is the leading cause of graft failure in pediatric heart transplant recipients, also adding to mortality in this patient population. Coronary angiography is routinely performed to screen for CAV, with conventional single-plane or bi-plane angiography being utilized. Dual-axis rotational coronary angiography (RA) has been described, mostly in the adult population, and may offer reduction in radiation dose and contrast volume. Experience with this in the pediatric population is limited. This study describes a single-institution experience with RA for screening for CAV in pediatric patients. The catheterization database at our institution was used to identify pediatric heart transplant recipients having undergone RA to screen for CAV. Procedural data including radiation dose, fluoroscopy time, contrast volume, and procedure time were collected for each catheterization. The number of instances in which RA was not successful, ECG changes were present, and CAV was detected were also collected for each catheterization. A total of 97 patients underwent 345 catheterizations utilizing RA. Median radiation dose-area product per kilogram was found to be 341.7 (mGy cm(2)/kg), total air kerma was 126.8 (mGy), procedure time was 69 min, fluoroscopy time was 9.9 min, and contrast volume was 13 ml. A total of 17 (2 %) coronary artery injections out of 690 could not be successfully imaged using RA. A total of 14 patients had CAV noted at any point, 10 of whom had progressive CAV. Electrocardiographic changes were documented in a total of 10 (3 %) RA catheterizations. Procedural characteristics did not differ between serial catheterizations. RA is safe and feasible for CAV screening in pediatric heart transplant recipients while offering coronary imaging in multiple planes compared to conventional angiography.

Author List

Rios R, Loomba RS, Foerster SR, Pelech AN, Gudausky TM

Authors

Susan Foerster MD Professor in the Pediatrics department at Medical College of Wisconsin
Todd M. Gudausky MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Cardiac Catheterization
Child
Child, Preschool
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Female
Fluoroscopy
Graft Rejection
Heart Transplantation
Humans
Infant
Infant, Newborn
Male
Postoperative Complications
Retrospective Studies
Wisconsin
Young Adult