Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology and Hepatology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Ophthalmology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
ASH 2024 Annual Meeting 2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Women’s Health Knowledge Hub Advances in Alzheimer’s

Navigating neuroimaging in Alzheimer disease care

PET imaging is playing an increasingly critical role in managing AD, but how can you effectively integrate it into clinical practice? Our expert-led program will empower you with practical strategies and real-world case studies.

This content is intended for healthcare professionals outside of the UK.
ADVANCED SEARCH
Log in
Top
Pediatric Radiology

14-04-2025 | Magnetic Resonance Imaging | Review

Practical approach to using cardiac magnetic resonance imaging for pre-surgical planning in complex paediatric congenital heart disease

Authors: Nicholas Michael Fitzgerald, Aakansha A Singh, David J Barron, Osami Honjo, Mike Seed, Israel Valverde, Shi-Joon Yoo, Christopher Z Lam

Published in: Pediatric Radiology

Login to get access

Abstract

Decision-making in complex congenital heart disease (CHD) is challenging and requires the integration of anatomic and physiological data. Recent advances in cross-sectional imaging, particularly cardiac magnetic resonance imaging (MRI), have refined this process. In addition to anatomic detail, MRI provides quantitative physiological data on cardiac function and flows through volumetry and phase contrast assessment. This review outlines the current scope for cardiac MRI and aims to provide a practical framework for using the data in four structural anomalies: borderline left ventricle, double outlet right ventricle, congenitally corrected transposition of the great arteries and Ebstein anomaly of the tricuspid valve.

Graphical Abstract

Literature
1.
Hickey EJ, Caldarone CA, McCrindle BW (2012) Left ventricular hypoplasia: a spectrum of disease involving the left ventricular outflow tract, aortic valve, and aorta. J Am Coll Cardiol 59:S43-54PubMedCrossRef
2.
Hickey EJ, Caldarone CA, Blackstone EH et al (2007) Critical left ventricular outflow tract obstruction: the disproportionate impact of biventricular repair in borderline cases. J Thorac Cardiovasc Surg 134:1429–1436PubMedCrossRef
3.
Mery CM, Nieto RM, De León LE et al (2017) The role of echocardiography and intracardiac exploration in the evaluation of candidacy for biventricular repair in patients with borderline left heart structures. Ann Thorac Surg 103:853–861PubMedCrossRef
4.
Haller C, Honjo O, Caldarone CA, Van Arsdell GS (2016) Growing the borderline hypoplastic left ventricle: hybrid approach. Oper Tech Thorac Cardiovasc Surg 21:124–138CrossRef
5.
Marathe SP, Piekarski B, Beroukhim RS et al (2021) Super Glenn for staged biventricular repair: impact on left ventricular growth? Eur J Cardiothorac Surg 60:534–541PubMedCrossRef
6.
Yerebakan C, Murray J, Valeske K et al (2015) Long-term results of biventricular repair after initial Giessen hybrid approach for hypoplastic left heart variants. J Thorac Cardiovasc Surg 149:1112–1122PubMedCrossRef
7.
Akintürk H, Yörüker U, Müller M, Schranz D (2022) Hypoplastic left ventricle: left ventricular recruitment with hybrid approach. World J Pediatr Congenit Heart Surg 13:637–644PubMedCrossRef
8.
Emani SM (2016) Staged left ventricular recruitment and biventricular conversion for patients with borderline left heart. Oper Tech Thorac Cardiovasc Surg 21:112–123CrossRef
9.
Grosse-Wortmann L, Yun TJ, Al-Radi O et al (2008) Borderline hypoplasia of the left ventricle in neonates: insights for decision-making from functional assessment with magnetic resonance imaging. J Thorac Cardiovasc Surg 136:1429–1436PubMedCrossRef
10.
Kang SL, Chaturvedi RR, Wan A et al (2022) Biventricular repair in borderline left hearts: insights from cardiac magnetic resonance imaging. JACC Adv 1:100066PubMedPubMedCentralCrossRef
11.
Tani LY, Minich LL, Pagotto LT et al (1999) Left heart hypoplasia and neonatal aortic arch obstruction: is the Rhodes left ventricular adequacy score applicable? J Thorac Cardiovasc Surg 118:81–86PubMedCrossRef
12.
Alboliras ET, Mavroudis C, Pahl E et al (1999) Left ventricular growth in selected hypoplastic left ventricles: outcome after repair of coarctation of aorta. Ann Thorac Surg 68:549–555PubMedCrossRef
13.
Kaplinski M, Cohen MS (2015) Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use? Cardiol Young 25:1482–1488PubMedCrossRef
14.
Rhodes LA, Colan SD, Perry SB et al (1991) Predictors of survival in neonates with critical aortic stenosis. Circulation 84:2325–2335PubMedCrossRef
15.
Lofland GK, McCrindle BW, Williams WG et al (2001) Critical aortic stenosis in the neonate: a multi-institutional study of management, outcomes, and risk factors. J Thorac Cardiovasc Surg 121:10–27PubMedCrossRef
16.
Colan SD, McElhinney DB, Crawford EC et al (2006) Validation and re-evaluation of a discriminant model predicting anatomic suitability for biventricular repair in neonates with aortic stenosis. J Am Coll Cardiol 47:1858–1865PubMedCrossRef
17.
Windram J, Grosse-Wortmann L, Shariat M et al (2012) Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants. Pediatr Radiol 42:183–187PubMedCrossRef
18.
Honjo O (2022) Integrating novel physiologic data into decision-making in congenital heart surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 25:19–27PubMedCrossRef
19.
Banka P, Schaetzle B, Komarlu R et al (2014) Cardiovascular magnetic resonance parameters associated with early transplant-free survival in children with small left hearts following conversion from a univentricular to biventricular circulation. J Cardiovasc Magn Reson 16:73PubMedPubMedCentralCrossRef
20.
Beattie MJ, Sleeper LA, Lu M et al (2023) Factors associated with morbidity, mortality, and hemodynamic failure after biventricular conversion in borderline hypoplastic left hearts. J Thorac Cardiovasc Surg 166:933-942.e3PubMedCrossRef
21.
Herrin MA, Zurakowski D, Baird CW et al (2017) Hemodynamic parameters predict adverse outcomes following biventricular conversion with single-ventricle palliation takedown. J Thorac Cardiovasc Surg 154:572–582PubMedCrossRef
22.
Bharucha T, Hlavacek AM, Spicer DE et al (2017) How should we diagnose and differentiate hearts with double-outlet right ventricle? Cardiol Young 27:1–15PubMedCrossRef
23.
Yim D, Dragulescu A, Ide H et al (2018) Essential modifiers of double outlet right ventricle revisit with endocardial surface images and 3-dimensional print models advances in cardiovascular imaging. Circ Cardiovasc Imaging 11:e006891PubMedCrossRef
24.
25.
Lam CZ, Pagano JJ, Gill N et al (2019) Dual phase infusion with bolus tracking: technical innovation for cardiac and respiratory navigated magnetic resonance angiography using extracellular contrast. Pediatr Radiol 49:399–406PubMedCrossRef
26.
27.
Valverde I, Gomez-Ciriza G, Hussain T et al (2017) Three-dimensional printed models for surgical planning of complex congenital heart defects: an international multicentre study. Eur J Cardiothorac Surg 52:1139–1148PubMedCrossRef
28.
Ponchant K, Nguyen DA, Prsa M et al (2023) Three-dimensional printing and virtual reconstruction in surgical planning of double-outlet right ventricle repair. JTCVS Tech 17:138–150PubMedCrossRef
29.
Lacour-Gayet F (2002) Biventricular repair of double outlet right ventricle with noncommitted ventricular septal defect. Pediatr Card Surg Annu 5:163–172
30.
Jost CHA, Connolly HM, Dearani JA et al (2007) Ebstein’s anomaly. Circulation 115:277–285CrossRef
31.
Carpentier A, Chauvaud S, Mace L et al (1988) A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 96:92–101PubMedCrossRef
32.
33.
Freud LR, McElhinney DB, Kalish BT et al (2020) Risk factors for mortality and circulatory outcome among neonates prenatally diagnosed with Ebstein anomaly or tricuspid valve dysplasia: a multicenter study. J Am Heart Assoc 9(21):e016684PubMedPubMedCentralCrossRef
34.
Brown ML, Dearani JA, Danielson GK et al (2008) The outcomes of operations for 539 patients with Ebstein anomaly. J Thorac Cardiovasc Surg 135:1120–1136PubMedCrossRef
35.
Konstantinov IE, Chai P, Bacha E et al (2024) The American Association for Thoracic Surgery (AATS) 2024 expert consensus document: management of neonates and infants with Ebstein anomaly. J Thorac Cardiovasc Surg 168:311–324PubMedCrossRef
36.
Pizarro C, Bhat MA, Davis DA et al (2022) Tailored strategy to match anatomy and physiology with intervention can improve outcomes of symptomatic neonates with Ebstein anomaly. JTCVS Open 12:344–354PubMedPubMedCentralCrossRef
37.
38.
Kumar SR, Kung G, Noh N et al (2016) Single-ventricle outcomes after neonatal palliation of severe Ebstein anomaly with modified Starnes procedure. Circulation 134:1257–1264PubMedCrossRef
39.
Holst KA, Dearani JA, Said S et al (2018) Improving results of surgery for Ebstein anomaly: where are we after 235 cone repairs? Ann Thorac Surg 105:160–168PubMedCrossRef
40.
Burri M, Mrad Agua K, Cleuziou J et al (2020) Cone versus conventional repair for Ebstein’s anomaly. J Thorac Cardiovasc Surg 160:1545–1553PubMedCrossRef
41.
Qureshi MY, Dearani JA (2021) Commentary: gold or silver? Value of cardiac magnetic resonance imaging over echocardiography in Ebstein’s anomaly. J Thorac Cardiovasc Surg 161:1109–1110PubMedCrossRef
42.
Pasqualin G, Boccellino A, Chessa M et al (2023) Ebstein’s anomaly in children and adults: multidisciplinary insights into imaging and therapy. Heart 110:235–244CrossRef
43.
Yalonetsky S, Tobler D, Greutmann M et al (2011) Cardiac magnetic resonance imaging and the assessment of Ebstein anomaly in adults. Am J Cardiol 107:767–773PubMedCrossRef
44.
Hösch O, Sohns JM, Nguyen TT et al (2014) The total right/left-volume index: a new and simplifed cardiac magnetic resonance measure to evaluate the severity of Ebstein anomaly of the tricuspid valve: a comparison with heart failure markers from various modalities. Circ Cardiovasc Imaging 7:601–609PubMedCrossRef
45.
Alsaied T, Castrillon CD, Christopher A et al (2022) Cardiac MRI predictors of right ventricular dysfunction after the Da Silva cone operation for Ebstein’s anomaly. Int J Cardiol Congenit Heart Dis 7:100342PubMedPubMedCentralCrossRef
46.
Celermajer DS, Cullen S, Sullivan ID et al (1992) Outcome in neonates with Ebstein’s anomaly. J Am Coll Cardiol 19:1041–1046PubMedCrossRef
47.
Rydman R, Shiina Y, Diller GP et al (2018) Major adverse events and atrial tachycardia in Ebstein’s anomaly predicted by cardiovascular magnetic resonance. Heart 104:37–44PubMedCrossRef
48.
Tobler D, Yalonetsky S, Crean AM et al (2013) Right heart characteristics and exercise parameters in adults with Ebstein anomaly: new perspectives from cardiac magnetic resonance imaging studies. Int J Cardiol 165:146–150PubMedCrossRef
49.
Beroukhim RS, Jing L, Harrild DM et al (2018) Impact of the cone operation on left ventricular size, function, and dyssynchrony in Ebstein anomaly: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 20:1–8CrossRef
50.
Qureshi MY, Sommer RJ, Cabalka AK (2019) Tricuspid valve imaging and intervention in pediatric and adult patients with congenital heart disease. JACC Cardiovasc Imaging 12:637–51PubMedCrossRef
51.
Hughes ML, Bonello B, Choudhary P et al (2019) A simple measure of the extent of Ebstein valve rotation with cardiovascular magnetic resonance gives a practical guide to feasibility of surgical cone reconstruction. J Cardiovasc Magn Reson 21:34PubMedPubMedCentralCrossRef
52.
53.
Neijenhuis RML, Tsang VT, Marek J et al (2021) Cone reconstruction for Ebstein anomaly: late biventricular function and possible remodeling. J Thorac Cardiovasc Surg 161:1097–1108PubMedCrossRef
54.
Fernandez-Badillo V, Serrano-Roman J, Antonio-Villa NE et al (2023) Assessment of left ventricular myocardial fibrosis in adult patients with Ebstein anomaly: a retrospective cohort study based on cardiac magnetic resonance and histopathological samples. Circ Cardiovasc Imaging 16:e015011PubMedCrossRef
55.
Teramachi Y, Hornberger L, Howley L et al (2022) Left ventricular dysfunction in neonatal Ebstein’s anomaly and tricuspid valve dysplasia. J Am Soc Echocardiogr 35:503-512.e3PubMedCrossRef
56.
Baumgartner H, Bonhoeffer P, De Groot NMS et al (2010) ESC guidelines for the management of grown-up congenital heart disease (new version 2010). EHJ 31:2915–57CrossRef
57.
Anzai I, Zhao Y, Dimagli A et al (2023) Outcomes after anatomic versus physiologic repair of congenitally corrected transposition of the great arteries: a systematic review and meta-analysis. World J Pediatr Congenit Heart Surg 14:70–6PubMedCrossRef
58.
Cui H, Hage A, Piekarski BL et al (2021) Management of congenitally corrected transposition of the great arteries with intact ventricular septum: anatomic repair or palliative treatment? Circ Cardiovasc Interv 14:e010154PubMedCrossRef
59.
Barrios PA, Zia A, Pettersson G et al (2021) Outcomes of treatment pathways in 240 patients with congenitally corrected transposition of great arteries. J Thorac Cardiovasc Surg 161:1080-1093.e4PubMedCrossRef
60.
Marathe SP, Chávez M, Schulz A et al (2022) Contemporary outcomes of the double switch operation for congenitally corrected transposition of the great arteries. J Thorac Cardiovasc Surg 164:1980-1990.e7PubMedCrossRef
61.
Bautista-Hernandez V, Myers PO, Cecchin F et al (2014) Late left ventricular dysfunction after anatomic repair of congenitally corrected transposition of the great arteries. J Thorac Cardiovasc Surg 148:254–258PubMedCrossRef
62.
Murtuza B, Barron DJ, Stumper O et al (2011) Anatomic repair for congenitally corrected transposition of the great arteries: a single-institution 19-year experience. J Thorac Cardiovasc Surg 142:1348–57.e1PubMedCrossRef
63.
Barron DJ, Mahendran K (2019) Left ventricular re-training: feasibility and effectiveness—what are the limits? Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 22:43–50PubMedCrossRef
64.
Mac Felmly L, Mainwaring RD, Ho DY et al (2024) Results of the double switch operation in patients who previously underwent left ventricular retraining. World J Pediatr Congenit Heart Surg 15:279–286PubMedCrossRef
65.
Myers PO, Del Nido PJ, Geva T et al (2013) Impact of age and duration of banding on left ventricular preparation before anatomic repair for congenitally corrected transposition of the great arteries. Ann Thorac Surg 96:603–610PubMedCrossRef
66.
Mainwaring RD, Patrick WL, Arunamata A et al (2020) Left ventricular retraining in corrected transposition: relationship between pressure and mass. J Thorac Cardiovasc Surg 159:2356–2366PubMedCrossRef
67.
Weixler VHM, Kramer P, Murin P et al (2022) Anatomic repair of congenitally corrected transposition: reappraisal of eligibility criteria. Pediatr Cardiol 43:1214–1222PubMedPubMedCentralCrossRef
Metadata
Title
Practical approach to using cardiac magnetic resonance imaging for pre-surgical planning in complex paediatric congenital heart disease
Authors
Nicholas Michael Fitzgerald
Aakansha A Singh
David J Barron
Osami Honjo
Mike Seed
Israel Valverde
Shi-Joon Yoo
Christopher Z Lam
Publication date
14-04-2025
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-025-06233-2

Keynote webinar | Spotlight on adolescent vaping

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Watch now
Video
Image Credits