- Oral presentation
- Open Access
CMR adenosine stress perfusion in pediatrics and congenital heart disease: effects on clinical decision making and outcomes
© Campbell et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Coronary Angiography
- Congenital Heart Disease
- Perfusion Defect
- Hypertrophic Cardiomyopathy
In contrast to adults with coronary artery disease (CAD), the use of CMR adenosine stress perfusion in pediatrics and in adults with congenital heart disease (CHD) is not well established. The medical literature reveals an absence of experience evaluating the effects of CMR adenosine stress perfusion on clinical decision making and outcomes in these populations.
Evaluate whether CMR adenosine stress perfusion in pediatrics and adults with CHD affects clinical decision making and outcomes.
Consecutive patients, who completed CMR adenosine stress perfusion and were < 21yo or > 21yo with CHD, were enrolled. SSFP cine and delayed enhancement CMR (DE-CMR) were performed in a standard manner. Adenosine stress perfusion was performed with administration of adenosine (140 ug/kg/min) for 2-4 minutes and gadolinium (0.1 mmol/kg) using a standard adult protocol. Perfusion defects matching infarct size on DE-CMR and defects corresponding to DE-CMR at the right ventricular insertion site or post-surgical changes were considered negative for ischemia.
Tetralogy of Fallot status post repair
Suspected hypertrophic cardiomyopathy
Anomalous left coronary artery arising from pulmonary artery-repaired
Left coronary artery arising from the right coronary sinus-repaired
Aortic stenosis status post Ross operation
Ventricular septal defect status post repair
Coarctation of the aorta status post surgical repair
Right coronary artery arising from the left coronary sinus-repaired
Anomalous right coronary artery arising from the pulmonary artery-repaired
Pulmonary atresia with intact ventricular septum
Transposition of the great arteries status post arterial switch operation
Transposition of the great arteries status post Mustard operation
Coarctation of the aorta status post transcatheter stent
Bicuspid aortic valve and HTN
Right coronary artery aneurysm, etiology unknown
Scimitar syndrome status post repair and coronary artery bypass graft
Congenitally corrected transposition of the great arteries
Hypoplastic right pulmonary artery, hypoplastic right coronary artery
Dysplastic pulmonary valve with pulmonary insufficiency
Sinus venosus atrial septal defect and partial anomalous pulmonary venous return-repaired
Previous abnormal diagnostic test
Nausea and fatigue
A negative finding on CMR adenosine stress perfusion often results in no further testing, indicating confidence in the result. A positive result can lead to further work-up and positively affect patient outcomes.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.