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PURPOSE: To characterize the recovery of diagnostic cardiovascular procedure volumes in U.S. and non-U.S. facilities in the year following the initial COVID-19 outbreak. MATERIALS AND METHODS: The International Atomic Energy Agency (IAEA) coordinated a worldwide study called the IAEA Noninvasive Cardiology Protocols Study of COVID-19 2 (INCAPS COVID 2), collecting data from 669 facilities in 107 countries, including 93 facilities in 34 U.S. states, to determine the impact of the pandemic on diagnostic cardiovascular procedure volumes. Participants reported volumes for each diagnostic imaging modality used at their facility for March 2019 (baseline), April 2020, and April 2021. This secondary analysis of INCAPS COVID 2 evaluated differences in changes in procedure volume between U.S. and non-U.S. facilities and among U.S. regions. Factors associated with return to prepandemic volumes in the United States were also analyzed in a multivariable regression analysis. RESULTS: Reduction in procedure volumes in April 2020 compared with baseline was similar for U.S. and non-U.S. facilities (-66% vs -71%, P = .27). U.S. facilities reported greater return to baseline in April 2021 than did all non-U.S. facilities (4% vs -6%, P = .008), but there was no evidence of a difference when comparing U.S. facilities with non-U.S. high-income country (NUHIC) facilities (4% vs 0%, P = .18). U.S. regional differences in return to baseline were observed between the Midwest (11%), Northeast (9%), South (1%), and West (-7%, P = .03), but no studied factors were significant predictors of 2021 change from prepandemic baseline. CONCLUSION: The reductions in cardiac testing during the early pandemic have recovered within a year to prepandemic baselines in the United States and NUHICs, while procedure volumes remain depressed in lower-income countries.Keywords: SPECT, Cardiac, Epidemiology, Angiography, CT Angiography, CT, Echocardiography, SPECT/CT, MR Imaging, Radionuclide Studies, COVID-19, Cardiovascular Imaging, Diagnostic Cardiovascular Procedure, Cardiovascular Disease, Cardiac Testing Supplemental material is available for this article. © RSNA, 2023. more...

Use of a valved Sano during the Norwood procedure has been reported previously, but its impact on clinical outcomes needs to be further elucidated. We assessed the impact of the valved Sano compared with the nonvalved Sano after the Norwood procedure in patients with hypoplastic left heart syndrome. We retrospectively reviewed 25 consecutive neonates with hypoplastic left heart syndrome who underwent a Norwood procedure with a valved Sano conduit using a femoral venous homograft and 25 consecutive neonates with hypoplastic left heart syndrome who underwent a Norwood procedure with a nonvalved Sano conduit between 2013 and 2022. Primary outcomes were end-organ function postoperatively and ventricular function over time. Secondary outcomes were cardiac events, all-cause mortality, and Sano and pulmonary artery reinterventions at discharge, interstage, and pre-Glenn time points. Postoperatively, the valved Sano group had significantly lower peak and postoperative day 1 lactate levels (P =.033 and P =.025, respectively), shorter time to diuresis (P =.043), and shorter time to enteral feeds (P =.038). The valved Sano group had significantly fewer pulmonary artery reinterventions until the Glenn operation (n = 1 vs 8; P =.044). The valved Sano group showed significant improvement in ventricular function from the immediate postoperative period to discharge (P <.001). From preoperative to pre-Glenn time points, analysis of ventricular function showed sustained ventricular function within the valved Sano group, but a significant reduction of ventricular function in the nonvalved Sano group (P =.003). Pre-Glenn echocardiograms showed competent conduit valves in two-thirds of the valved Sano group (n = 16; 67%). The valved Sano is associated with improved multi-organ recovery postoperatively, better ventricular function recovery, and fewer pulmonary artery reinterventions until the Glenn procedure. [Display omitted] [ABSTRACT FROM AUTHOR] more...

Purpose: To characterize the recovery of diagnostic cardiovascular procedure volumes in U.S. and non-U.S. facilities in the year following the initial COVID-19 outbreak., Materials and Methods: The International Atomic Energy Agency (IAEA) coordinated a worldwide study called the IAEA Noninvasive Cardiology Protocols Study of COVID-19 2 (INCAPS COVID 2), collecting data from 669 facilities in 107 countries, including 93 facilities in 34 U.S. states, to determine the impact of the pandemic on diagnostic cardiovascular procedure volumes. Participants reported volumes for each diagnostic imaging modality used at their facility for March 2019 (baseline), April 2020, and April 2021. This secondary analysis of INCAPS COVID 2 evaluated differences in changes in procedure volume between U.S. and non-U.S. facilities and among U.S. regions. Factors associated with return to prepandemic volumes in the United States were also analyzed in a multivariable regression analysis., Results: Reduction in procedure volumes in April 2020 compared with baseline was similar for U.S. and non-U.S. facilities (-66% vs -71%, P = .27). U.S. facilities reported greater return to baseline in April 2021 than did all non-U.S. facilities (4% vs -6%, P = .008), but there was no evidence of a difference when comparing U.S. facilities with non-U.S. high-income country (NUHIC) facilities (4% vs 0%, P = .18). U.S. regional differences in return to baseline were observed between the Midwest (11%), Northeast (9%), South (1%), and West (-7%, P = .03), but no studied factors were significant predictors of 2021 change from prepandemic baseline., Conclusion: The reductions in cardiac testing during the early pandemic have recovered within a year to prepandemic baselines in the United States and NUHICs, while procedure volumes remain depressed in lower-income countries. Keywords: SPECT, Cardiac, Epidemiology, Angiography, CT Angiography, CT, Echocardiography, SPECT/CT, MR Imaging, Radionuclide Studies, COVID-19, Cardiovascular Imaging, Diagnostic Cardiovascular Procedure, Cardiovascular Disease, Cardiac Testing Supplemental material is available for this article. © RSNA, 2023., Competing Interests: Disclosures of conflicts of interest: C.B.H. No relevant relationships. S.D. Research grants to author’s institution from Pfizer, GE HealthCare, Attralus, Siemens, and Philips; consulting fees from AstraZeneca and Novo Nordisk; support from Novo Nordisk for travel to an advisory board meeting. L.J.S. No relevant relationships. T.C.V. No relevant relationships. A.D.C. Grant support from GW Heart and Vascular Institute; consultant for Siemens Healthineers; equity in Cleerly. N.B. No relevant relationships. R.J.C. No relevant relationships. G.K. No relevant relationships. J.V.V. No relevant relationships. M.C.W. Support from the British Heart Foundation (FS/ICRF/20/26002); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or education events from Canon Medical Systems, Siemens Healthineers, and Novartis; member of the Radiology: Cardiothoracic Imaging editorial board. M.A.M. Research support from Siemens; consulting fees from Jubilant and Philips; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Jubilant. D.S.B. Receives software royalties from Cedars-Sinai Medical Center; consultant for General Electric and Bayer. A.B. No relevant relationships. R.W.B. No relevant relationships. P.E.B. No relevant relationships. M.J.B. Grant support from General Electric. R.P.B.P. Women as One grant ($25 000), paid to author’s institution; Knowledge to Practice honoraria ($500) for being a panelist during a virtual educational event; honoraria ($1000, $2500) from American College of Radiology for CME education products; member of American Society of Nuclear Cardiology board of directors, Intersocietal Accreditation Commission CT board of directors, and American College of Cardiology board of governors. M.Y.C. No relevant relationships. M.P.D. Salary support from Genentech for COVID-19 research. R.D. No relevant relationships. M.F. Grants or contracts from the National Institutes of Health (NIH) and the American Heart Association (AHA); consulting fees from Biography, Elucid, HeartFlow, and Siemens Healthineers; vice-president of the Society of Cardiovascular Computed Tomography; stock or stock options in Elucid. J.B.G. No relevant relationships. F.G.H. Grant support from GE HealthCare. R.C.H. No relevant relationships. L.K. Member of the Radiology: Cardiothoracic Imaging editorial board. V.L.M. Grants or contracts from the NIH, AHA, and Siemens; consulting fees from Siemens, INVIA Medical Imaging Solutions, and Ionetix; member of AHA Cardiovascular Radiology and Interventions Council Leadership Committee and the American Society of Nuclear Cardiology Program Committee; stock in General Electric, Ionetix, and Cardinal Health; scientific advisor to Ionetix; received software from INVIA Medical Imaging Solutions. J.N. No relevant relationships. P.F.R.L. Grants or contracts from iTHRIV Scholar, which is supported in part by the National Center for Advancing Translational Sciences of the NIH (award nos. UL1TR003015 and KL2TR003016); patent planned, issued, or pending number 3062/140PCT/US for "Methods, systems, and computer-readable media for utilizing US device to perform MV decalcification." N.R.S. Grant support from Pfizer; stock in General Electric. A.S. No relevant relationships. P.S. Grant funding from Pfizer to author’s institution and from Astellas; royalties from UpToDate; personal consulting fees from Bridgebio (Eidos), Spectrum Dynamics, Pfizer, and Alnylam; member of the American Society of Nuclear Cardiology board of directors. R.C.T. No relevant relationships. D.W. Consultant for Astellas, BridgeBio, Pfizer, and Alnylam advisory boards; payment for speakers bureaus work from Astellas and Pfizer; chair of ASNC Health Policy Committee; member of advisory boards of Bridge Bio and Alynylam, and grant interviewer for Ionis. Y.A.C. No relevant relationships. E.M. No relevant relationships. M.J.R. No relevant relationships. J.L.M. No relevant relationships. P.P. Consulting fees from Medtronic and AstraZeneca. M.S. No relevant relationships. T.N.B.P. No relevant relationships. Y.P. No relevant relationships. M.D. No relevant relationships. D.P. No relevant relationships. A.J.E. Support from the International Atomic Energy Agency to Columbia University; grants from GE HealthCare, Canon Medical Systems, W.L. Gore & Associates, Eidos Therapeutics, Attralus, Pfizer, Roche Medical Systems, and Neovasc to Columbia University; speaker’s fees from Ionetix; consulting fees from W. L. Gore & Associates; support from the Society of Nuclear Medicine and Molecular Imaging for attending meetings and/or travel; patents planned, issued, or pending for Columbia Technology Ventures; leadership or fiduciary role in the American College of Cardiology, American Society of Nuclear Cardiology, and the Society of Nuclear Medicine and Molecular Imaging; and authorship fees from Wolters Kluwer Healthcare–UpToDate., (© 2023 by the Radiological Society of North America, Inc.) more...