Technical Feasibility on the Use of Optical Coherence Tomography in the Evaluation of Pediatric Pulmonary Venous Stenosis

Abstract Pulmonary vein stenosis (PVS) in children is a morbid disease and limited progress has been made in improving outcomes for this heterogenous group of patients. Evaluation is currently limited to imaging techniques that fail to provide an adequate overview of the intraluminal and luminal pathology perpetuating our limited understanding of this condition. Optical coherence tomography (OCT) is an imaging modality which provides intraluminal profiling with microstructural detail through optical reflective technology. We sought to evaluate whether its use was technically feasible in pediatric PVS and whether the imaging data provided potentially useful outputs for clinical utility. Eleven patients were prospectively selected from our cardiac catheterization for OCT evaluation of their pulmonary veins (PV) during elective catheterization for PVS. Measurements were taken both pre and post intervention using both manual and automated tools. Stent morphology was characterized. Eleven patients had evaluation of 34 pulmonary veins, with 7 patients having more than one assessment, for a total of 25 overall catheterizations. Most patients were female (75%). Median age at cardiac catheterization was 35 months (range 5–45 months). Median weight of subjects was 10.6 kg (3.7–14.2) with a median BSA documented at 0.505 $ m^{2} $ (0.21–0.57). Median number of pulmonary veins involved was 3, (range 1–5 veins) and median contrast volume of 2.9 mL/kg (0.7–3.7) given. Median radiation dose (DAP) was 6095 µGy·$ cm^{2} $ (1670–12,400). Median number of previous cardiac catheterizations was 7 (range 1–11). All of the vessels with a diameter < 5 mm were adequately visualized. Of all the OCT images acquired, in 15 vessels (44%) contrast was used to clear the vessels from blood as an angiogram was required at the time, in the other 19 vessels (56%), saline was used with adequate imaging. There were no complications related to OCT. OCT is technically feasible to use in pediatric patients without any directly related complications. It provides intraluminal anatomy in children with both native and treated pulmonary venous stenosis when vessel size is less than 5 mm..

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:43

Enthalten in:

Pediatric cardiology - 43(2022), 5 vom: 17. Jan., Seite 1054-1063

Sprache:

Englisch

Beteiligte Personen:

Zablah, Jenny E. [VerfasserIn]
O’Callaghan, Barry [VerfasserIn]
Shorofsky, Michael [VerfasserIn]
Ivy, Dunbar [VerfasserIn]
Morgan, Gareth J. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Congenital heart disease
Optical coherence tomography
Pediatric cardiac catheterization
Prematurity
Pulmonary venous stenosis

RVK:

RVK Klassifikation

Anmerkungen:

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022

doi:

10.1007/s00246-022-02824-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2130449816

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