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5. What can we learn from systematic segmental analysis of fetal heart by postmortem micro-CT: Is it time to change approach?

Author

Sandrini, C., primary, Lombardi, C.M., additional, Zambelli, V., additional, Zanarotti, R., additional, Raffaelli, R., additional, Franchi, M.P., additional, Papadopoulos, N., additional, Di Pace, C., additional, Hoxha, S., additional, Murari, A., additional, Chamitava, L., additional, Zanolin, M.E., additional, Faggian, G., additional, Ribichini, F.L., additional, Rossetti, L., additional, and Luciani, G.B., additional

Published
2021
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9. BEST ORAL ABSTRACTS1575Extracellular volume associates with outcomes more strongly than native or post-contrast myocardial T11507Cardiac Magnetic Resonance measured Extracellular Volume Independently Predicts Adverse Outcome in Heart Failure with Preserved Ejection Fraction1457Cardiac MRI Under Percussive Ventilation: A New Promising Technique1644Histological Validation of Cardiac Magnetic Resonance for the Evaluation of Myocardial Fibrosis after Heart Transplantation in Children1493First Pass Perfusion Reserve Index in Paediatric Patients with Arterial Switch for Transposition of Great Arteries1652Myocardial Fibrosis is Prevalent in Obstructive Sleep Apnea and Associated with Hospitalization for Heart Failure or Death

Author

Treibel, Thomas A., primary, Duca, Franz, primary, Schwitter, Juerg, primary, Ide, Seiko, primary, Sandrini, C., primary, Fridman, Yaron, primary, Fridman, Yaron, additional, Hackman, Brianne, additional, Kadakkal, Ajay, additional, Sayeed, Aatif, additional, Maanja, Maren, additional, Daya, Hussein Abu, additional, Moon, James C., additional, Wong, Timothy C., additional, Schelbert, Erik B., additional, Kammerlander, Andreas A., additional, Zotter-Tufaro, Caroline, additional, Aschauer, Stefan, additional, Bonderman, Diana, additional, Mascherbauer, Julia, additional, Beigelman-Aubry, Catherine, additional, Peguret, Nicolas, additional, Stuber, Matthias, additional, Delacoste, Jean, additional, Belmondo, Bastien, additional, Lovis, Alban, additional, Simons, Julien, additional, Long, Olivier, additional, Grant, Kathleen, additional, Berchier, Gregoire, additional, Rohner, Chantal, additional, Bonanno, Gabriele, additional, Coppo, Simone, additional, Ozsahin, Esat-Mahmut, additional, Qanadli, Salah, additional, Meuli, Reto, additional, Bourhis, Jean, additional, Riesenkampff, Eugenie, additional, Chiasson, David, additional, Dipchand, Anne I., additional, Kantor, Paul F., additional, Chaturvedi, Rajiv R., additional, Yoo, Shi-Joon, additional, Grosse-Wortmann, Lars, additional, Aquaro, GD, additional, De Marchi, D, additional, Ait Ali, L, additional, Khraiche, D, additional, Boddaert, N, additional, Bonnet, D, additional, Raimondi, F, additional, and Hackman, Brianne E., additional

Published
2016
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11. Abstracts

Author

Treibel, Thomas A., Fridman, Yaron, Hackman, Brianne, Kadakkal, Ajay, Sayeed, Aatif, Maanja, Maren, Daya, Hussein Abu, Moon, James C., Wong, Timothy C., Schelbert, Erik B., Duca, Franz, Kammerlander, Andreas A., Zotter-Tufaro, Caroline, Aschauer, Stefan, Bonderman, Diana, Mascherbauer, Julia, Schwitter, Juerg, Beigelman-Aubry, Catherine, Peguret, Nicolas, Stuber, Matthias, Delacoste, Jean, Belmondo, Bastien, Lovis, Alban, Simons, Julien, Long, Olivier, Grant, Kathleen, Berchier, Gregoire, Rohner, Chantal, Bonanno, Gabriele, Coppo, Simone, Ozsahin, Esat-Mahmut, Qanadli, Salah, Meuli, Reto, Bourhis, Jean, Ide, Seiko, Riesenkampff, Eugenie, Chiasson, David, Dipchand, Anne I., Kantor, Paul F., Chaturvedi, Rajiv R., Yoo, Shi-Joon, Grosse-Wortmann, Lars, Sandrini, C., Aquaro, GD, De Marchi, D, Ait Ali, L, Khraiche, D, Boddaert, N, Bonnet, D, Raimondi, F, Fridman, Yaron, Hackman, Brianne E., Kadakkal, Ajay, Daya, Hussein Abu, Wong, Timothy C., Schelbert, Erik B., Angela, Susana, Alberto, Cipriani, Manuel, De Lazzari, Federico, Marin, Francesca, Prevedello, Bendetta, Giorgi, Giorgio, De Conti, Giuseppe, Tarantini, Luisa, Cacciavillani, Emanuele, Bertaglia, Domenico, Corrado, Sabino, Iliceto, Martina, Perazzolo Marra, Camaioni, Claudia, Morlon, Lucas, Vergé, Marie-Philippe, Jais, Pierre, Roudaut, Raymond, Laurent, Francois, Lafitte, Stéphane, Cochet, Hubert, Réant, Patricia, Bohnen, S., Radunski, U. K., Lund, G. K., Senel, M., Avanesov, M., Tahir, E., Stehning, C., Adam, G., Blankenberg, S., Muellerleile, K., Khanji, Mohammed Y., Balawon, Armida, Boubertakh, Redha, Petersen, Steffen E, Hilbert, Sebastian, Spampinato, Ricardo, Oebel, Sabrina, Hindricks, Gerhard, Bollmann, Andreas, Jahnke, Cosima, Paetsch, Ingo, Goetschalckx, K., Bogaert, J., Desmet, W., Toth, A., Merkely, B., Janssens, S., Claus, P., Calvieri, C., Preda, M. B., Perfetti, A., Valaperta, R., Secchi, F., Fedele, F., Martelli, F., Lombardi, M., Reinstadler, Sebastian J., Eitel, Charlotte, Fuernau, Georg, de Waha, Suzanne, Desch, Steffen, Mende, Meinhard, Metzler, Bernhard, Schuler, Gerhard, Thiele, Holger, Eitel, Ingo, Maestrini, Viviana, Mun, Hong Cheang, Kotwinski, Paul, Rosmini, Stefania, Sanders, Julie, Lloyd, Guy, Dudley, J. Pennell, Kellman, Peter, Hugh, E. Montgomery, Manisty, Charlotte, James, C. Moon, James, S., Waterhouse, D.F., Murphy, T.M., Kenny, C., O'Hanlon, R., Bastiaenen, Rachel, Cox, Andrew T., Wijeyeratne, Yanushi, Colbeck, Nicholas, Pakroo, Nadia, Ahmed, Hammad, Bunce, Nick, Anderson, Lisa, Prasad, Sanjay, Sharma, Sanjay, Behr, Elijah R., Reid, A. B., Miller, C., Jovanovic, A., Woolfson, P., Abidin, N., Schmitt, M., Amadu, A.M., Rodrigues, J.C.L., Dastidar, A. Ghosh, Baritussio, A., Lawton, C., Venuti, G., Meloni, G.B., Conti, M., Bucciarelli-Ducci, C., Pontone, Gianluca, Andreini, Daniele, SoLbiati, Anna, Guglielmo, Marco, Mushtaq, Saima, Baggiano, Andrea, Beltrama, Virginia, Rota, Cristina, Guaricci, Andrea I., Pepi, Mauro, Wang, Yufei, Joannic, David, Juillion, Patrick, Delassus, P., Monnet, Aurélien, Lalande, Alain, Fontaine, Jean-Francois, Zweerink, A, Allaart, CP, Wu, L, Kuijer, JPA, Beek, AM, Croisille, P, Clarysse, P, van Rossum, AC, Nijveldt, R, Bulluck, Heerajnarain, Rosmini, Stefania, Abdel-Gadir, Amna, Bhuva, Anish, Treibel, Thomas A, White, Steven K, Hammond-Haley, Matthew, Sirker, Alex, Herrey, Anna, Manisty, Charlotte, Yellon, Derek M, Kellman, Peter, Moon, James C, Hausenloy, Derek J, Garg, P., Hassell, M, Foley, J., Ripley, D.P., Dobson, L., Swoboda, P.P., Fent, G., Musa, T.A., Erhayiem, B., Haaf, P., Greenwood, J.P., Nijveldt, R., Westenberg, J.J.M., Geest, R.J.V.D., Plein, S., Rodrigues, Jonathan C L, Amadu, Antonio Matteo, Dastidar, Amardeep Ghosh, Szantho, Gergley, Lyen, Stephen, Godsave, Cattleya, Ratcliffe, Laura E K, Burchell, Amy E, Hart, Emma C, Hamilton, Mark C K, Nightingale, Angus K, Paton, Julian F R, Manghat, Nathan E, Bucciarelli-Ducci, Chiara, Hafyane, Tarik, Teixeira, Tiago, Greiser, Andreas, Mongeon, Francois Pierre, Haifa, Almutairi, Mohammed, Khanji, Redha, Boubertakh, Marc, Miquel, Steffen, Petersen, Greulich, S., Kitterer, D., Latus, J., Henes, J., Kurmann, R., Gloekler, S., Wahl, A., Buss, S., Katus, H., Bobbo, M., Lombardi, M., Braun, N., Alscher, M.D., Sechtem, U., Mahrholdt, H., Meloni, A., Neri, M.G., Preziosi, P., Grassedonio, E., Schicchi, N., Keilberg, P., Pulini, S., Facchini, E., Positano, V., Pepe, A., Nazir, Sheraz A., Shetye, Abhishek, Khan, Jamal N., Singh, Anvesha, Kanagala, Prathap, Swarbrick, Daniel, Gulsin, Gaurav, Graham-Brown, Matthew, Squire, Iain, Gershlick, Anthony, McCann, Gerry P., Stefan Biesbroek, P., Amier, Raquel P., Teunissen, Paul F.A., Robbers, Lourens F.H.J., Beek, Aernout M., van Rossum, Albert C., Hofman, Mark B.M., van Royen, Niels, Nijveldt, Robin, Arenja, Nisha, Riffel, Johannes H, Djiokou, Charly Noel, Andre, Florian, Fritz, Thomas, Halder, Manuel, Thomas, Zelniker, Korosoglou, Grigorios, Katus, Hugo A, Buss, Sebastian J, Kammerlander, Andreas A., Schwaiger, Marianne L., Duca, Franz, Aschauer, Stefan, Marzluf, Beatrice A., Zotter-Tufaro, Caroline, Dalos, Daniel, Pfaffenberger, Stefan, Bonderman, Diana, Mascherbauer, Julia, Sayeed, Aatif, Fridman, Yaron, Hackman, Brianne, Kadakkal, Ajay, Maanja, Maren, Daya, Hussein Abu, Wong, Timothy C., Schelbert, Erik B., Ricci, F., Barison, A., Todiere, G., Gaeta, R., Galllina, S., Emdin, M., De Caterina, R., Aquaro, G.D., Bernhardt, Peter, Buckert, Dominik, Dyckmanns, Nils, Rottbauer, Wolfgang, Meierhofer, Christian, Kühn, Andreas, Shehu, Nerejda, Müller, Jan, Stern, Heiko, Ewert, Peter, Fratz, Sohrab, Vogt, Manfred, Devos, Daniel G.H., De Groote, Katya, Babin, Danilo, Demulier, Laurent, Taeymans, Yves, Westenberg, Jos J., Van Bortel, Luc, Segers, Patrick, Achten, Eric, De Schepper, Jean, Rietzschel, Ernst, Ruecker, Beate, Geiger, Julia, Makki, Malek, Burkhardt, Barbara, Kellenberger, Christian J., Buechel, Emanuela R. Valsangiacomo, Burkhardt, B.E.U., Kellenberger, C.J., Geiger, J., Ruecker, B., Buechel, E.R. Valsangiacomo, Kamphuis, Vivian P., Elbaz, Mohammed S.M., Kroft, Lucia J.M., van der Geest, Rob J., de Roos, Albert, Blom, Nico A., Westenberg, Jos J.M., Roest, Arno A.W., De Lazzari, Manuel, Cipriani, Alberto, Susana, Angela, Rizzo, Stefania, Giorgi, Benedetta, Carmelo, Lacognata, Bertaglia, Emanuele, Bauce, Barbara, Corrado, Domenico, Thiene, Gaetano, Marra, Martina Perazzolo, Basso, Cristina, Iliceto, Sabino, Nederend, I., Roest, A.A.W., van den Boogaard, P.J., ten Harkel, A.D.J., de Geus, J.C.N., Kroft, L.J.M., de Roos, A., Westenberg, J.J.M., Dux-Santoy, Lydia, Kale, Raquel, Teixido-Tura, Gisela, Maldonado, Giuliana, Huguet, Marina, Garcia-Dorado, David, Evangelista, Artur, Rodriguez-Palomares, Jose, Cavalcante, João L., Rijal, Shasank, Schindler, John T., Gleason, Thomas G., Lee, Joon S., Schelbert, Erik B., Rosmini, Stefania, Bulluck, Heerajnarain, Treibel, Thomas A, Bhuva, Anish, Abdel-Gadir, Amna, Culotta, Veronica, Merghani, Ahmed, Maestrini, Viviana, Herrey, Anna S, Kellman, Peter, Manisty, Charlotte, Moon, James C, Liu, B., Hayer, M.K., Baig, S., Shah, T., Rooney, S.J., Edwards, N.C., Steeds, R.P., Fent, G.J., Garg, P., Swoboda, P., Dobson, L.E., Musa, T.A., Foley, J.F., Haaf, P., Greenwood, J.P., Plein, S., Claessen, G., Schnell, F., Bogaert, J., Dymarkowski, S., Pattyn, N., Claus, P., Van Cleemput, J., Gerche, A. La, Heidbuchel, H., Behar, Jonathan, Toth, Daniel, Reiml, Sabrina, Panayiotou, Maria, Claridge, Simon, Jackson, Tom, Sohal, Manav, Webb, Jessica, O'Neill, Mark, Brost, Alexander, Mountney, Peter, Razavi, Reza, Rhode, Kawal, Rinaldi, Christopher Aldo, Oebel, S., Arya, A., Hilbert, S., Bollmann, A., Hindricks, G., Jahnke, C., Paetsch, I., Dinov, B., Baritussio, A., Perazzolo Marra, M., Ghosh Dastidar, A., Rodrigues, J., Zorzi, A., Susana, A., Scatteia, A., De Garate, E., Mattesi, G., Strange, J., Corrado, D., Bucciarelli-Ducci, C., Ranjit Arnold, J., Jerosch-Herold, Michael, Karamitsos, Theodoros D., Francis, Jane M., Bhamra-Ariza, Paul, Sarwar, Rizwan, Choudhury, Robin, Selvanayagam, Joseph B., Neubauer, Stefan, Tayal, Upasana, Scott, Andrew D, Wage, Rick, Ferreira, Pedro, Pennell, Dudley, Zhong, Xiaodong, Epstein, Fred, Firmin, David, Prasad, Sanjay, Kallifatidis, Alexandros, Prousalis, Anastasios, Mouratoglou, Sophia-Anastasia, Giannakoulas, George, Deligianni, Xenia, Bakaloudis, Michail, Magganaris, Nikolaos, Sianos, George, Karvounis, Haralampos, Santini, Francesco, Garg, P., Aziz, R., Foley, J.R.J., Fent, G., Musa, T.A., Haaf, P., Dobson, L., Swoboda, P.P., Greenwood, J.P., Plein, S., Geest, R.J.V.D., Westenberg, J.J.M., Beitzke, D., Rasul, S., Wadsak, W., Mitterhauser, M., Nolz, R., Stelzmueller, M., Loewe, C., Hacker, M., Funk, Stephanie, Kermer, Josephine, Dogangüzel, Serkan, von Knobelsdorff-Brenkenhoff, Florian, Schulz-Menger, Jeanette, Kolker, Shimon, Weisz, Giora, Bogot, Naama, Halpern, Irit Hadas, Wolak, Arik, Rutz, Tobias, Ginami, Giulia, Piccini, Davide, Coppo, Simone, Vincenti, Gabriella, Stuber, Matthias, Schwitter, Jürg, Safdar, Komal S, Gao, Xuexin, Ambach, Stephanie, Taylor, Michal D, Moore, Ryan, Taylor, Robin J, Toro-Salazar, Olga, Jeffries, John L, Bartone, Cheryl, Raman, Subha V, Mazur, Wojciech, Valente, F., Rodriguez-Palomares, J.F., Gutierrez, L., Pineda, V., Agliano, B., Galian, L., Teixido, G., Gonzalez-Alujas, M.T., Evangelista, A., Garcia-Dorado, D., Murdoch, R., Gandy, S., Nicholas, R., Houston, G., Martin, P., Muir, J., Matthew, S., Ramkumar, P. Guntur-, Cavin, I., Macaione, F., Barison, A., Pescetelli, I., Pali, F., Pizzino, F., Terrizzi, A., Di Lisi, D., Novo, G., Todiere, G., Assennato, P., Novo, S., Aquaro, G.D., Dastidar, Amardeep Ghosh, McAlindon, Elisa, Rodrigues, Jonathan, Baritussio, Anna, Scatteia, Alessandra, De Garate, Estefania, Benny Lawton, Chris, Erdei, Tamas, Szantho, Gergely, Hamilton, Mark, Bucciarelli-Ducci, Chiara, Pontone, Gianluca, Andreini, Daniele, Rota, Cristina, Guglielmo, Marco, Mushtaq, Saima, Baggiano, Andrea, Beltrama, Virginia, Solbiati, Anna, Guaricci, Andrea I., Pepi, Mauro, Grigoratos, Chrysanthos, Bratis, Konstantinos, Henningson, Markus, Dell'Omodarme, Matteo, Puntmann, Valentina O., Nagel, Eike, Meloni, Antonella, Giunta, Nicola, Giuliano, Pietro, Neri, Maria Giovanna, Restaino, Gennaro, Renne, Stefania, Quota, Alessandra, Positano, Vincenzo, De Marchi, Daniele, Pepe, Alessia, Pedrotti, Patrizia, Campadello, Paola, Masciocco, Gabriella, Facchetti, Rita, Milazzo, Angela, Quattrocchi, Giuseppina, Giannattasio, Cristina, Frigerio, Maria, Roghi, Alberto, Rimoldi, Ornella, De Garate, Estefania, Ghosh Dastidar, Amardeep, Baritussio, Anna, Scatteia, Alessandra, Amadu, Antonio, Venuti, Giuseppe, Rodrigues, Jonathan C., Bucciarelli-Ducci, Chiara, Careri, Giulia, Castelvecchio, Serenella, Camporeale, Antonia, Secchi, Francesco, Menicanti, Lorenzo, Lombardi, Massimo, Kockova, R., Sedlacek, K., Wichterle, D., Sikula, V., Tintera, J., Sukupova, L., Kautznerova, D., Segetova, M., Praveckova, A., Langova, R., Kryze, L., El-Husseini, W., Kautzner, J., Oebel, S., Dinov, B., Arya, A., Hilbert, S., Sommer, P., Bollmann, A., Hindricks, G., Paetsch, I., Jahnke, C., Nazir, Sheraz A., Greenwood, John P., Shetye, Abhishek, Khan, Jamal N., Singh, Anvesha, Kanagala, Prathap, Swarbrick, Daniel, Gulsin, Gaurav, Graham-Brown, Matthew, Gershlick, Anthony, McCann, Gerry P., Grigoratos, Chrysanthos, Liga, Riccardo, Bennatti, Elena, Barison, Andrea, Todiere, Giancarlo, Aquaro, Giovanni Donato, Dell'Omodarme, Matteo, Lombardi, Massimo, Emdin, Michele, Masci, Pier Giorgio, Barison, A, Ortalda, A, Todiere, G, Grigoratos, C, Vergaro, G, Mirizzi, G, Martini, N, De Marchi, D, Keilberg, P, Passino, C, Aquaro, GD, Emdin, M, Swoboda, Peter P, McDiarmid, Adam K, Erhayiem, Bara, Fent, Graham J, Dobson, Laura E, Garg, Pankaj, Musa, Tarique A, Foley, James R, Page, Stephen P, Greenwood, John P, Plein, Sven, Bulluck, Heerajnarain, Rosmini, Stefania, Abdel-Gadir, Amna, Bhuva, Anish, Treibel, Thomas A, White, Steven K, Fontana, Marianna, Ramlall, Manish, Hamarneh, Ashraf, Sirker, Alex, Herrey, Anna, Manisty, Charlotte, Yellon, Derek M, Kellman, Peter, Moon, James C, Hausenloy, Derek J, Broncano, J., Luna, A., Noguerol, T. Martin –, Caro, P., Toro-Cebada, R., Gonzalez, J. Sanchez –, Desroche, L.M., Milleron, O., Safar, B., Lavie-Badie, Y., Millischer, D., Abtan, J., Jondeau, G., Bermejo, Zorba Blázquez, Cuesta, Emilio, Rosillo, Sandra O., Guzmán, Gabriela, Pinilla, Inmaculada, González, Óscar, Caro, Juan, Ponz, Inés, López, Teresa, Refoyo, Elena, Kozor, Rebecca, Nordin, Sabrina, Treibel, Thomas A, Rosmini, Stefania, Castelleti, Silvia, Fontana, Marianna, Captur, Gabriella, Steeds, Rick, Baig, Shanat, Manisty, Charlotte, Grieve, Stuart M, Figtree, Gemma A, Moon, James C, Dastidar, Amardeep Ghosh, Rodrigues, Jonathan, De Garate, Estefania, Singhal, Priyanka, McAlindon, Elisa, Baritussio, Anna, Scatteia, Alessandra, Erdei, Tamas, Strange, Julian, Nightingale, Angus, Baumbach, Andreas, Johnson, Tom, Delgado, Victoria, Bucciarelli-Ducci, Chiara, Lapinskas, Tomas, Bucius, Paulius, Fedaravicius, Augustinas P., Urbonaite, Laura, Stabinskaite, Agnieta, Zaliunas, Remigijus, Elisabetta, Chiodi, Teresa, Cannizzaro Maria, Daniele, De Falco Alfano, Righi, Riccardo, Zerbini, Michela, Vincenzo, Positano, Cittanti, Corrado, Giganti, Melchiore, Giorgio, Benea, Grigoratos, Chrysanthos, Genovesi, Dario, Giorgetti, Assuero, Chiappino, Sara, Barison, Andrea, Vergaro, Giuseppe, Todiere, Giancarlo, Emdin, Michele, Marzullo, Paolo, Aquaro, Giovanni Donato, Ladeiras-Lopes, Ricardo, Turin-Moreira, Henrique, Bettencourt, Nuno, Fontes-Carvalho, Ricardo, Sampaio, Francisco, Ambale-Venkatesh, Bharath, Wu, Colin, Liu, Kiang, Bertoni, Alain, Ouyang, Pamela, Bluemke, David, Lima, João, Fent, GJ., Garg, P., Dobson, LE., Musa, TA., Foley, JF., Haaf, P., Greenwood, JP., Plein, S., Swoboda, PP., Abdul Rahman, E., Ismail, JR., Najme Khir, R., Lim, CW., Chua, N., Ibrahim, ZO., Zainal Abidin, HA., Mohd Arshad, MK., Kasim, SS., Rodrigues, Jonathan, Rooms, Ben, Hyde, Katie, Rohan, Stephen, Dastidar, Amardeep Ghosh, Hamilton, Mark, Bucciarelli-Ducci, Chiara, Nightingale, Angus, Paton, Julian, Manghat, Nathan, MacIver, David, Gibelli, Giuseppe, Demolli, Walter, Russo, Alessandra, Minoia, Chiara, Biasi, Salvatore, Mkrtchyan, Naira, Eltschkner, Christin, Christian, Meierhofer, Ewert, Peter, Martinoff, Stefan, Stern, Heiko, Fratz, Sohrab, Valinoti, Maddalena, Fabbri, Claudio, Mantovan, Roberto, Severi, Stefano, Corsi, Cristiana, Nyktari, E., Vassiliou, V., Arzanauskaite, M., Izgi, C., Lam, W., Prasad, S., Reindl, Martin, Reinstadler, Sebastian Johannes, Feistritzer, Hans-Josef, Klug, Gert, Mair, Johannes, Mayr, Agnes, Jaschke, Werner, Franz, Wolfgang-Michael, Metzler, Bernhard, Arnhold, K., Muehlberg, F., Fritschi, S., Funk, S., Prothmann, M., von Knobelsdorff-Brenkenhoff, F., Schulz-Menger, J., Lakhani, Zeeshan S. A., Mohan, B., karthik, G A., Raj, Vimal, Weir-McCall, Jonathan, Cassidy, Deirdre B, Belch, Jill JF, Gandy, Stephen J, Houston, Graeme, Lambert, Matthew A, Littleford, Roberta, Rowland, Janice, Struthers, Allan D, Khan, Faisel, Camaioni, Claudia, Salel, Marjorie, Hennig, Alexia, Corneloup, Olivier, Montaudon, Michel, Laurent, Francois, Cochet, Hubert, Kan, Rachel, Erhayiem, Bara, McDiarmid, Adam K., Garg, Pankaj, Dobson, Laura E., Musa, Tarique A., Ripley, David, Ajjan, Ramzi, Greenwood, John P., Plein, Sven, Swoboda, Peter P., Reinstadler, Sebastian J., Fuernau, Georg, Eitel, Charlotte, de Waha, Suzanne, Desch, Steffen, Metzler, Bernhard, Schuler, Gerhard, Thiele, Holger, Eitel, Ingo, Feistritzer, Hans-Josef, Reinstadler, Sebastian Johannes, Klug, Gert, Reindl, Martin, Mair, Johannes, Mayr, Agnes, Franz, Wolfgang-Michael, Metzler, Bernhard, Feistritzer, Hans-Josef, Klug, Gert, Reinstadler, Sebastian Johannes, Reindl, Martin, Mayr, Agnes, Franz, Wolfgang-Michael, Metzler, Bernhard, Festa, P., Cadoni, A., D'andrea, C., Costa, S., Keilberg, P., Lunardini, A., Ali, L. Ait, Ali, L. Ait, Aquaro, GD., Peritore, G., Ricci, F., De Marchi, D., Passino, C., Festa, P., Martínez, A. Tercero, Cuartero, J. Navarro, Soriano, J.G. Córdoba, Núñez, S. Calero, de Galarreta, T. Cros Ruiz, García, M. Villar, Page, J.C. Gallego, López, J.C. García, Ruiz, M. 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Abstract

Objectives: Myocardial fibrosis in noninfarcted myocardium is emerging as a principal phenotype of vulnerability to adverse events such as mortality and hospitalization for heart failure (HHF), but its optimal noninvasive measurement remains uncertain despite consistently robust histologic validation data for extracellular volume fraction (ECV). We therefore compared ECV, native T1, post contrast T1, the gadolinium contrast partition coefficient (lambda), and the presence of nonischemic scar in their associations with mortality and HHF outcomes. Method: To quantify of myocardial fibrosis, we performed T1 mapping (MOLLI) in basal and mid short axis slices with cardiovascular magnetic resonance (CMR) before contrast and 12-30 minutes post contrast bolus in 1185 consecutive patients without amyloidosis, hypertrophic or stress cardiomyopathy. We assessed associations with outcomes using Kaplan-Meier plots and chi square values from univariable Cox regression models. All standard T1 mapping parameters were obtained: native and post contrast myocardial T1, the partition coefficient lambda, and ECV. ECV = (1-hematocrit) · [ΔR1myocardium]/[ΔR1bloodpool], where R1 = 1/T1 Late gadolinium enhancement imaging with phase sensitive reconstruction identified nonischemic scar. Results: Over a median of 1.7 years, 111 individuals experienced events after CMR: 55 HHF events and 74 deaths. ECV yielded better separation of Kaplan-Meier curves in a dose dependent fashion (Figure) and also stronger associations with the combined endpoint of death or HHF. The ECV chi square (77.3, p < 0.001) was at least twice as large as the Native T1 chi square (37.5, p < 0.001), the lambda chi square (34.8, p < 0.001) and nonischemic scar (chi square = 20.5, p<0.001). Post-contrast T1 was not associated with outcomes, even when adjusting further for time after contrast bolus, renal function, and patient weight (chi square <3, p >0.10). Conclusion: Analogous to histologic previously published validation data, quantitative ECV myocardial fibrosis measures associated with outcomes far stronger than other surrogate measures outcome measures such as native T1, post contrast T1 and nonischemic scar on LGE images. These data suggest that ECV is the noninvasive metric of choice to measure myocardial fibrosis. Figure. Kaplan-Meier Plots for T1 mapping parameters.

Published
2016
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12. Accuracy of Micro-Computed Tomography in Post-mortem Evaluation of Fetal Congenital Heart Disease. Comparison Between Post-mortem Micro-CT and Conventional Autopsy

Author

Roberta Zanarotti, Concetta Di Pace, Roberta Soldá, Stiljan Hoxha, Vanessa Zambelli, Camilla Sandrini, Flavio Ribichini, Franca Bettinazzi, Giovanni Battista Luciani, Claudio M. Lombardi, Lucia Rossetti, Giuseppe Faggian, Sandrini, C, Rossetti, L, Zambelli, V, Zanarotti, R, Bettinazzi, F, Solda, R, Di Pace, C, Hoxha, S, Ribichini, F, Faggian, G, Lombardi, C, and Luciani, G

Subjects
medicine.medical_specialty, Heart disease, Prenatal diagnosi, Prenatal diagnosis, 030204 cardiovascular system & hematology, fetal echocardiography, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, early prenatal diagnosis, 030225 pediatrics, medicine, Medical diagnosis, Original Research, prenatal diagnosis, medicine.diagnostic_test, business.industry, lcsh:RJ1-570, post mortem micro-computed tomography, Gestational age, lcsh:Pediatrics, Early prenatal diagnosi, Gold standard (test), medicine.disease, Pediatrics, Perinatology and Child Health, Congenital heart disease-cardiac, Gross anatomy, Tomography, Radiology, congenital heart disease—cardiac, business, Fetal echocardiography
Abstract

Aims: Early prenatal diagnosis of congenital heart disease is feasible. Conventional autopsy is the current gold standard method for post-mortem confirmation. Radiologic techniques alternative to conventional autopsy, such as post-mortem micro-computed tomography, have been proposed in case of limited diagnostic accuracy (i.e., early termination of pregnancy, samples of small dimension or of low weight). The aim of the present study was to define accuracy of micro-computed tomography for post-mortem diagnosis of congenital heart disease in gross anatomy samples. Methods and Results: Fetal heart underwent in-utero prenatal echocardiography and ex-vivo post-mortem evaluation by 9 μm resolution micro-computed tomography and conventional autopsy. For each case, 25 indices of cardiac anatomy were studied by post-mortem micro-computed tomography and conventional autopsy; these were used to compare the two post mortem techniques. Ten samples were examined (gestational age between 12 + 4 and 21 + 6 weeks of gestation). Considering comparable indices, agreement between post-mortem micro-computed tomography and conventional autopsy was of 100% and sensitivity and specificity were of 100%. In “challenging specimens,” post-mortem micro-computed tomography diagnoses more indices as compared to conventional autopsy and 84% of “not-diagnostic” indices at conventional autopsy would be diagnostic at post-mortem micro-computed tomography. Conclusion: Micro-computed tomography can be a valid diagnostic alternative to conventional autopsy for post-mortem evaluation of human fetal heart. In addition, it may prove superior to conventional autopsy particularly in cases coming from early termination of pregnancy or in samples of small dimension or of low weight.

Published
2019

13. Recommendations for cardiovascular magnetic resonance and computed tomography in congenital heart disease: a consensus paper from the CMR/CCT Working Group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology endorsed by the Italian Society of Medical and Interventional Radiology (Part II).

Author

Festa P, Lovato L, Bianco F, Alaimo A, Angeli E, Baccano G, Barbi E, Bennati E, Bonhoeffer P, Bucciarelli V, Curione D, Ciliberti P, Clemente A, Di Salvo G, Esposito A, Ferroni F, Gaeta A, Giovagnoni A, Inserra MC, Leonardi B, Marcora S, Marrone C, Peritore G, Pergola V, Pluchinotta F, Puppini G, Stagnaro N, Raimondi F, Sandrini C, Spaziani G, Tchana B, Trocchio G, Ait-Ali L, and Secinaro A

Subjects
Humans, Italy, Tomography, X-Ray Computed standards, Cardiology standards, Magnetic Resonance Imaging standards, Child, Predictive Value of Tests, Adult, Societies, Medical standards, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital therapy, Consensus
Abstract

Cardiovascular magnetic resonance (CMR) and computed tomography (CCT) are advanced imaging modalities that recently revolutionized the conventional diagnostic approach to congenital heart diseases (CHD), supporting echocardiography and often replacing cardiac catheterization. This is the second of two complementary documents, endorsed by experts from the Working Group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology of the Italian Society of Medical and Interventional Radiology, aimed at giving updated indications on the appropriate use of CMR and CCT in different clinical CHD settings, in both pediatrics and adults. In this article, support is also given to radiologists, pediatricians, cardiologists, and cardiac surgeons for indications and appropriateness criteria for CMR and CCT in the most referred CHD, following the proposed new criteria presented and discussed in the first document. This second document also examines the impact of devices and prostheses for CMR and CCT in CHD and additionally presents some indications for CMR and CCT exams when sedation or narcosis is needed., (Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Published
2024
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14. Overcoming Underpowering in the Outcome Analysis of Repaired-Tetralogy of Fallot: A Multicenter Database from the CMR/CT Working Group of the Italian Pediatric Cardiology Society (SICPed).

Author

Ait-Ali L, Leonardi B, Alaimo A, Baccano G, Bennati E, Bucciarelli V, Clemente A, Favilli S, Ferroni F, Inserra MC, Lovato L, Maiorano A, Marcora SA, Marrone C, Martini N, Mirizzi G, Pasqualin G, Peritore G, Puppini G, Sandrini C, Raimondi F, Secchi F, Spaziani G, Stagnaro N, Salvadori S, Secinaro A, Tchana B, Trocchio G, Galetti D, Pieroni F, Dalmiani S, Bianco F, and Festa P

Abstract

Background: Managing repaired tetralogy of Fallot (TOF) patients is still challenging despite the fact that published studies identified prognostic clinical or imaging data with rather good negative predictive accuracy but weak positive predictive accuracy. Heterogeneity of the initial anatomy, the surgical approach, and the complexity of the mechanism leading to dilation and ventricular dysfunction explain the challenge of predicting the adverse event in this population. Therefore, risk stratification and management of this population remain poorly standardized. Design: The CMR/CT WG of the Italian Pediatric Cardiology Society set up a multicenter observational clinical database of repaired TOF evaluations. This registry will enroll patients retrospectively and prospectively assessed by CMR for clinical indication in many congenital heart diseases (CHD) Italian centers. Data collection in a dedicated platform will include surgical history, clinical data, imaging data, and adverse cardiac events at 6 years of follow-up. Summary: The multicenter repaired TOF clinical database will collect data on patients evaluated by CMR in many CHD centers in Italy. The registry has been set up to allow future research studies in this population to improve clinical/surgical management and risk stratification of this population.

Published
2023
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15. Recommendations for cardiovascular magnetic resonance and computed tomography in congenital heart disease: a consensus paper from the CMR/CCT working group of the Italian Society of Pediatric Cardiology (SICP) and the Italian College of Cardiac Radiology endorsed by the Italian Society of Medical and Interventional Radiology (SIRM) Part I.

Author

Secinaro A, Ait-Ali L, Curione D, Clemente A, Gaeta A, Giovagnoni A, Alaimo A, Esposito A, Tchana B, Sandrini C, Bennati E, Angeli E, Bianco F, Ferroni F, Pluchinotta F, Rizzo F, Secchi F, Spaziani G, Trocchio G, Peritore G, Puppini G, Inserra MC, Galea N, Stagnaro N, Ciliberti P, Romeo P, Faletti R, Marcora S, Bucciarelli V, Lovato L, and Festa P

Subjects
Adult, Child, Consensus, Humans, Magnetic Resonance Spectroscopy, Radiology, Interventional, Tomography, X-Ray Computed, Cardiology, Heart Defects, Congenital diagnostic imaging
Abstract

Cardiovascular magnetic resonance (CMR) and computed tomography (CCT) are advanced imaging modalities that recently revolutionized the conventional diagnostic approach to congenital heart diseases (CHD), supporting echocardiography and often replacing cardiac catheterization. Nevertheless, correct execution and interpretation require in-depth knowledge of all technical and clinical aspects of CHD, a careful assessment of risks and benefits before each exam, proper imaging protocols to maximize diagnostic information, minimizing harm. This position paper, written by experts from the Working Group of the Italian Society of Pediatric Cardiology and from the Italian College of Cardiac Radiology of the Italian Society of Medical and Interventional Radiology, is intended as a practical guide for applying CCT and CMR in children and adults with CHD, wishing to support Radiologists, Pediatricians, Cardiologists and Cardiac Surgeons in the multimodality diagnostic approach to these patients. The first part provides a review of the most relevant literature in the field, describes each modality's advantage and drawback, making considerations on the main applications, image quality, and safety issues. The second part focuses on clinical indications and appropriateness criteria for CMR and CCT, considering the level of CHD complexity, the clinical and logistic setting and the operator expertise., (© 2022. The Author(s).)

Published
2022
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16. Congenital Heart Disease: Growth Evaluation and Sport Activity in a Paediatric Population.

Author

Zoller T, Prioli MA, Clemente M, Pilati M, Sandrini C, Luciani GB, Deganello Saccomani M, Ficial B, Gaffuri M, Piacentini G, Calciano L, and Pietrobelli A

Abstract

(1) Objective: To evaluate: (i) the associations of age and disease severity with anthropometric indices and weight status, (ii) the difference in the frequency of sports activity among different levels of disease severity in paediatric patients with congenital heart disease (CHD). (2) Methods: Clinical data of Caucasian children (aged 2-18 years) diagnosed with CHD (2005-2018) were retrospectively collected from the electronic register of outpatient visits. Of the 475 children with CHD, 368 children and their 1690 complete anthropometric measurements were eligible for inclusion in our analysis. (3) Results: Significant increase with age was observed for weight z-score [beta (95%CI): 0.03 (0.02, 0.05) for one-unit of age] and BMI z-score [0.06 (0.03, 0.08)] but not for height z-score. The probability of being underweight and overweight/obese increased and decreased with disease severity, respectively. The obesity probability of patients with mild CHD (0.06 [95%CI: 0.03, 0.08]) was not statistically distinguishable from that of patients with moderate CHD (0.03 [95%CI: 0.02, 0.05]), whereas it was lower in patients with severe CHD (0.004 [95%CI: 0.0, 0.009]). No obese patients with a univentricular heart defect were observed. Days spent in sport activities were equal to 1.9 [95%CI: 1.6, 2.2] days/week, 1.9 [1.5, 2.2], 1.4 [1.1, 1.7] and 0.7 [0.1, 1.3] in patients with mild, moderate, severe and univentricular CHD, respectively. (4) Conclusions: The risk of being overweight and obese should not be underestimated in paediatric patients diagnosed with CHD, especially in children with mild or moderate heart defects. It could be prevented or reduced by promoting a healthy lifestyle.

Published
2022
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17. Cor Triatriatum and Intracardiac Anomalous Pulmonary Venous Return: An Inborn Atrial Flow Inversion.

Author

Poretti G, Hoxha S, Segreto A, Sandrini C, Murari A, Prioli MA, Faggian G, and Luciani GB

Subjects
Echocardiography, Heart Atria, Humans, Infant, Newborn, Cor Triatriatum diagnostic imaging, Cor Triatriatum surgery, Pulmonary Veins abnormalities, Pulmonary Veins diagnostic imaging, Pulmonary Veins surgery, Scimitar Syndrome diagnostic imaging, Scimitar Syndrome surgery
Abstract

A neonate with a diagnosis of nonobstructive intracardiac type total anomalous pulmonary venous connection presented with profound cyanosis in the first days of life. The preoperative specialist echocardiographic examination also identified the presence of partial cor triatriatum dexter. The anatomic pattern of this exceedingly rare disease's association, its peculiar clinical presentation, and surgical management are discussed., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2022
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18. Feasibility, Reproducibility and Reference Ranges of Left Atrial Strain in Preterm and Term Neonates in the First 48 h of Life.

Author

Ficial B, Corsini I, Clemente M, Cappelleri A, Remaschi G, Quer L, Urbani G, Sandrini C, Biban P, Dani C, and Benfari G

Abstract

Left atrial strain (LAS) is the most promising technique for assessment of diastolic dysfunction but few data are available in neonates. Our aim was to assess feasibility and reproducibility, and to provide reference ranges of LAS in healthy neonates in the first 48 h of life. We performed one echocardiography in 30 neonates to assess feasibility and develop a standard protocol for image acquisition and analysis. LAS reservoir (LASr), conduit (LAScd) and contraction (LASct) were measured. We performed echocardiography at 24 and 48 h of life in an unrelated cohort of 90 neonates. Median (range) gestational age and weight of the first cohort were 34.4 (26.4-40.2) weeks and 2075 (660-3680) g. LAS feasibility was 96.7%. Mean (SD) gestational age and weight of the second cohort were 34.2 (3.8) weeks and 2162 (833) g. Mean (SD) LASr significantly increased from 24 to 48 h: 32.9 (3.2) to 36.8 (4.6). Mean (SD) LAScd and LASct were stable: -20.6 (8.0) and -20.8 (9.9), -11.6 (4.9) and -13.5 (6.4). Intra and interobserver intraclass correlation coefficient for LASr, LAScd and LASct were 0.992, 0.993, 0.986 and 0.936, 0.938 and 0.871, respectively. We showed high feasibility and reproducibility of LAS in neonates and provided reference ranges.

Published
2022
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19. Preliminary Results of Cryoablation for Surgical Treatment of Arrhythmias in Adults With Congenital Heart Disease.

Author

Poretti G, Hoxha S, Segreto A, Jacopo G, Sandrini C, Faggian G, Varrica A, Chessa M, Giamberti A, and Luciani GB

Abstract

Background: Arrhythmias in adult congenital heart disease (ACHD) are responsible for the majority of hospital admissions and 20-25% of late deaths. Since need for further cardiac operations is frequent in ACHD, concomitant arrhythmia surgery represents a strategic treatment modality. Material and Methods: A two-center retrospective study was undertaken on cryoablation of supraventricular arrhythmias in 25 conescutive ACHD patients (16/9, M/F, median age 38.5 years, IQR 38-60) operated between 01/2017 and 12/2020. Nineteen (76%) had undergone one or more previous cardiac operations and 8 (32%) one or more trans-catheter ablations. Indications included Fontan conversion in seven patients, septal defect repair in 6, pulmonary valve replacement in 10 and tricuspid surgery in 2. Open-heart cryoablation included: 4 cavotricuspid isthmus ablations, 19 right-sided Maze for atrial tachycardia/flutter, and 2 Cox-Maze III for atrial fibrillation. Results: There were 2 (8%) hospital deaths, unrelated to cryoablation, due to low cardiac output syndrome. There were no intraoperative complications related to cryoablation. Seven (28%) patients required pace-maker implantation due to post-operative atrioventricular block. All patients were discharged on oral antiarrhythmic and anticoagulantion for 6 months. After a median follow-up of 14 months (IQR 7-27) no late mortality was observed. At follow-up, 16/23 (69%) patients are in stable sinus rhythm, 12 without anti-arrhythmic therapy. Two (8.6%) patients had relapse of arrhythmia. Freedom from arrhythmia was 90.9% and cumulative risk of recurrence was 9.6%. Conclusions: Intraoperative cryoablation is safe and effective procedure. Surgical treatment of arrhythmias should always be considered in ACHD, whenever further open-heart repair is needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Poretti, Hoxha, Segreto, Jacopo, Sandrini, Faggian, Varrica, Chessa, Giamberti and Luciani.)

Published
2021
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20. Postmortem Micro-CT of Human Fetal Heart-A Systematic Literature Review.

Author

Sandrini C, Boito S, Lombardi CM, and Lombardi S

Abstract

Micro-computed tomography (CT) is a non-invasive alternative to conventional macroscopic dissection for the evaluation of human fetal cardiac anatomy. This paper aims to systematically review the literature regarding the use of micro-CT to examine human fetal hearts, to illustrate its educational and research implications and to explain its possible directions for the future. A systematic literature review was conducted following the PRISMA statement to identify publications concerning micro-CT applications for the isolated human fetal heart. The search strategy identified nine eligible studies. Micro-CT is technically feasible for postmortem examination of the human fetal heart coming from early and late termination of pregnancy. It reaches high diagnostic accuracy, and it seems to perform better than autopsy in small samples or in the case of early termination of pregnancy. Applications derived from micro-CT allow multiple off-time evaluations and interdisciplinary comparisons for educational purposes and research perspectives in biological and bioengineering domains.

Published
2021
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22. Right ventricular functional recovery depends on timing of pulmonary valve replacement in tetralogy of Fallot: a video kinematic study.

Author

Rozzi G, Lo Muzio FP, Fassina L, Rossi S, Statello R, Sandrini C, Laricchiuta M, Faggian G, Miragoli M, and Luciani GB

Subjects
Biomechanical Phenomena, Humans, Treatment Outcome, Pulmonary Valve, Pulmonary Valve Insufficiency, Tetralogy of Fallot
Abstract

Objectives: Indications for and timing of pulmonary valve replacement (PVR) after tetralogy of Fallot repair are controversial. Among magnetic resonance imaging indices proposed to time valve replacement, a right ventricular (RV) end-diastolic volume index greater than 160 ml/m2 is often used. Recent evidence suggests that this value may still identify patients with irreversible RV dysfunction, thus hindering recovery. Our goal was to define, using intraoperative video kinematic evaluation, whether a relationship exists between timing of PVR and early functional recovery after surgery., Methods: Between November 2016 and November 2018, a total of 12 consecutive patients aged 27.1 ± 19.1 years underwent PVR on average 22.2 ± 13.3 years after tetralogy of Fallot repair. Mean RV end-diastolic volume evident on the magnetic resonance images was 136.9 ± 35.7 ml/m2. Intraoperative cardiac kinematics were assessed by video kinematic evaluation via a high-speed camera acquiring videos at 200 fps before and after valve replacement., Results: Patients presenting with RV end-diastolic volume <147 ml/m2 were significantly younger (11.2 ± 5.0 vs 38.4 ± 17.0; P = 0.005) and had a shorter time interval to valve replacement (11.0 ± 5.2 vs 30.1 ± 11.3; P = 0.03). The entire population showed a moderate correlation among energy expenditure, cardiac fatigue, perimeter of contraction and preoperative RV end-diastolic volume index. Both groups showed a reduction in all kinematic parameters after PVR, but those with end-diastolic volume >147 ml/m2 showed an unpredictable outcome., Conclusions: Video kinematic evaluation provides insight into intraoperative RV recovery in patients with tetralogy of Fallot undergoing PVR. Accordingly, functional recovery can be expected in patients with preoperative end-diastolic volume <147 ml/m2., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2021
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23. Efficacy of Diving Reflex in Near-Term Fetal Tachycardia.

Author

Papa M, Mauri L, Sandrini C, Persico N, and Colli AM

Subjects
Adult, Female, Humans, Pregnancy, Cryotherapy methods, Diving Reflex, Fetal Diseases therapy, Fetal Therapies methods, Tachycardia, Supraventricular therapy
Abstract

Background: Sustained fetal supraventricular tachycardia is a potentially life-threatening disorder and is usually treated by administering antiarrhythmia drugs to the mother, which can require at least 48-72 hours to achieve normal sinus rhythm. In neonates with supraventricular tachycardia, first-line treatment is stimulation of the vagus nerve to elicit the diving reflex, commonly by application of a cold pack to the face, with a high, albeit sometimes temporary, success rate., Case: We describe a case of fetal supraventricular tachycardia at term treated successfully by eliciting the diving reflex with an ice pack to the maternal abdomen over the lower uterine segment. The neonate was given propranolol augmented with flecainide because of recurrent supraventricular tachycardia. He remained in a stable sinus rhythm without side effects 5 months later., Conclusions: Cardioversion of fetal supraventricular tachycardia at term by eliciting the diving reflex could be offered to allow normal labor and vaginal delivery., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Published
2021
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24. Three-Dimensional Printing of Fetal Models of Congenital Heart Disease Derived From Microfocus Computed Tomography: A Case Series.

Author

Sandrini C, Lombardi C, Shearn AIU, Ordonez MV, Caputo M, Presti F, Luciani GB, Rossetti L, and Biglino G

Abstract

This article presents a case series of n = 21 models of fetal cardiovascular anatomies obtained from post mortem microfocus computed tomography (micro-CT) data. The case series includes a broad range of diagnoses (e.g., tetralogy of Fallot, hypoplastic left heart syndrome, dextrocardia, double outlet right ventricle, atrio-ventricular septal defect) and cases also had a range of associated extra-cardiac malformations (e.g., VACTERL syndrome, central nervous system anomalies, renal anomalies). All cases were successfully reconstructed from the microfocus computed tomography data, demonstrating the feasibility of the technique and of the protocols, including in-house printing with a desktop 3D printer (Form2, Formlabs). All models were printed in 1:1 scale as well as with the 5-fold magnification, to provide insight into the intra-cardiac structures. Possible uses of the models include education and training., (Copyright © 2020 Sandrini, Lombardi, Shearn, Ordonez, Caputo, Presti, Luciani, Rossetti and Biglino.)

Published
2020
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25. Real-time video kinematic evaluation of the in situ beating right ventricle after pulmonary valve replacement in patients with tetralogy of Fallot: a pilot study.

Author

Rozzi G, Lo Muzio FP, Sandrini C, Rossi S, Fassina L, Faggian G, Miragoli M, and Luciani GB

Subjects
Adolescent, Biomechanical Phenomena, Child, Female, Humans, Magnetic Resonance Imaging, Male, Pilot Projects, Prognosis, Pulmonary Valve Insufficiency complications, Tetralogy of Fallot complications, Time Factors, Treatment Outcome, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right physiopathology, Young Adult, Cardiac Surgical Procedures, Pulmonary Valve Insufficiency diagnostic imaging, Pulmonary Valve Insufficiency surgery, Tetralogy of Fallot diagnostic imaging, Tetralogy of Fallot surgery, Ventricular Dysfunction, Right diagnostic imaging
Abstract

Objectives: The timing for pulmonary valve replacement (PVR) after tetralogy of Fallot repair is controversial, due to limitations in estimating right ventricular dysfunction and recovery. Intraoperative imaging could add prognostic information, but transoesophageal echocardiography is unsuitable for exploring right heart function. Right ventricular function after PVR was investigated in real time using a novel video-based contactless kinematic evaluation technology (Vi.Ki.E.), which calculates cardiac fatigue and energy consumption., Methods: Six consecutive patients undergoing PVR at 13.8 ± 2.6 years (range 6.9-19.8) after the repair of tetralogy of Fallot were enrolled. Mean right ventricular end-diastolic and end-systolic volume at magnetic resonance imaging were 115.6 ± 16.2 ml/m2 and 61.5 ± 14.6 ml/m2, respectively. Vi.Ki.E. uses a fast-resolution camera placed 45 cm above the open chest, recording cardiac kinematics before and after PVR. An algorithm defines cardiac parameters, such as energy, fatigue, maximum contraction velocity and tissue displacement., Results: There were no perioperative complications, with patients discharged in satisfactory clinical conditions after 7 ± 2 days (range 5-9). Vi.Ki.E. parameters describing right ventricular dysfunction decreased significantly after surgery: energy consumption by 45% [271 125 ± 9422 (mm/s)2 vs 149 202 ± 11 980 (mm/s)2, P = 0.0001], cardiac fatigue by 12% (292 671 ± 29 369 mm/s2 vs 258 755 ± 42 750 mm/s2, P = 0.01), contraction velocity by 54% (3412 ± 749 mm/s vs 1579 ± 400 mm/s, P = 0.0007) and displacement by 23% (27 ± 4 mm vs 21 ± 4 mm, P = 0.01). Patients undergoing PVR at lower end-diastolic volumes, had greater functional recovery of Vi.Ki.E. parameters., Conclusions: Intraoperative Vi.Ki.E shows immediate recovery of right ventricular mechanics after PVR with less cardiac fatigue and energy consumption, providing novel insights that may have a prognostic relevance for functional recovery., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2019
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26. Accuracy of Micro-Computed Tomography in Post-mortem Evaluation of Fetal Congenital Heart Disease. Comparison Between Post-mortem Micro-CT and Conventional Autopsy.

Author

Sandrini C, Rossetti L, Zambelli V, Zanarotti R, Bettinazzi F, Soldá R, Di Pace C, Hoxha S, Ribichini FL, Faggian G, Lombardi C, and Luciani GB

Abstract

Aims: Early prenatal diagnosis of congenital heart disease is feasible. Conventional autopsy is the current gold standard method for post-mortem confirmation. Radiologic techniques alternative to conventional autopsy, such as post-mortem micro-computed tomography, have been proposed in case of limited diagnostic accuracy (i.e., early termination of pregnancy, samples of small dimension or of low weight). The aim of the present study was to define accuracy of micro-computed tomography for post-mortem diagnosis of congenital heart disease in gross anatomy samples. Methods and Results: Fetal heart underwent in-utero prenatal echocardiography and ex-vivo post-mortem evaluation by 9 μm resolution micro-computed tomography and conventional autopsy. For each case, 25 indices of cardiac anatomy were studied by post-mortem micro-computed tomography and conventional autopsy; these were used to compare the two post mortem techniques. Ten samples were examined (gestational age between 12 + 4 and 21 + 6 weeks of gestation). Considering comparable indices, agreement between post-mortem micro-computed tomography and conventional autopsy was of 100% and sensitivity and specificity were of 100%. In "challenging specimens," post-mortem micro-computed tomography diagnoses more indices as compared to conventional autopsy and 84% of "not-diagnostic" indices at conventional autopsy would be diagnostic at post-mortem micro-computed tomography. Conclusion: Micro-computed tomography can be a valid diagnostic alternative to conventional autopsy for post-mortem evaluation of human fetal heart. In addition, it may prove superior to conventional autopsy particularly in cases coming from early termination of pregnancy or in samples of small dimension or of low weight.

Published
2019
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27. Cardiac Magnetic Resonance Myocardial Perfusion After Arterial Switch for Transposition of Great Arteries.

Author

Raimondi F, Aquaro GD, De Marchi D, Sandrini C, Khraiche D, Festa P, Ait Ali L, Boddaert N, and Bonnet D

Subjects
Adolescent, Child, Coronary Stenosis etiology, Coronary Stenosis physiopathology, Humans, Predictive Value of Tests, Retrospective Studies, Risk Factors, Time Factors, Transposition of Great Vessels diagnostic imaging, Transposition of Great Vessels physiopathology, Treatment Outcome, Young Adult, Arterial Switch Operation adverse effects, Coronary Circulation, Coronary Stenosis diagnostic imaging, Magnetic Resonance Imaging, Cine, Myocardial Perfusion Imaging methods, Transposition of Great Vessels surgery
Published
2018
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28. Selective Cerebro-Myocardial Perfusion in Complex Neonatal Aortic Arch Pathology: Midterm Results.

Author

Hoxha S, Abbasciano RG, Sandrini C, Rossetti L, Menon T, Barozzi L, Linardi D, Rungatscher A, Faggian G, and Luciani GB

Subjects
Aortic Diseases mortality, Cardiopulmonary Bypass adverse effects, Cardiopulmonary Bypass instrumentation, Cardiopulmonary Bypass methods, Circulatory Arrest, Deep Hypothermia Induced adverse effects, Circulatory Arrest, Deep Hypothermia Induced methods, Coronary Vessels physiopathology, Feasibility Studies, Female, Follow-Up Studies, Heart physiopathology, Humans, Hypothermia, Induced instrumentation, Hypothermia, Induced methods, Infant, Newborn, Ischemia etiology, Ischemia physiopathology, Male, Nervous System Diseases epidemiology, Nervous System Diseases etiology, Perfusion adverse effects, Perfusion instrumentation, Retrospective Studies, Time Factors, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures instrumentation, Aorta, Thoracic surgery, Aortic Diseases surgery, Brain blood supply, Perfusion methods, Vascular Surgical Procedures methods
Abstract

Aortic arch repair in newborns and infants has traditionally been accomplished using a period of deep hypothermic circulatory arrest. To reduce neurologic and cardiac dysfunction related to circulatory arrest and myocardial ischemia during complex aortic arch surgery, an alternative and novel strategy for cerebro-myocardial protection was recently developed, where regional low-flow perfusion is combined with controlled and independent coronary perfusion. The aim of the present retrospective study was to assess short-term and mid-term results of selective and independent cerebro-myocardial perfusion in neonatal aortic arch surgery. From April 2008 to August 2015, 28 consecutive neonates underwent aortic arch surgery under cerebro-myocardial perfusion. There were 17 male and 11 female, with median age of 15 days (3-30 days) and median body weight of 3 kg (1.6-4.2 kg), 9 (32%) of whom with low body weight (<2.5 kg). The spectrum of pathologies treated was heterogeneous and included 13 neonates having single-stage biventricular repair (46%), 7 staged biventricular repair (25%), and 8 single-ventricle repair (29%). All operations were performed under moderate hypothermia and with a "beating heart and brain." Average cardiopulmonary bypass time was 131 ± 64 min (42-310 min). A period of cardiac arrest to complete intra-cardiac repair was required in nine patients (32%), and circulatory arrest in 1 to repair total anomalous pulmonary venous connection. Average time of splanchnic ischemia during cerebro-myocardial perfusion was 30 ± 11 min (15-69 min). Renal dysfunction, requiring a period of peritoneal dialysis was observed in 10 (36%) patients, while liver dysfunction was noted only in 3 (11%). There were three (11%) early and two late deaths during a median follow-up of 2.9 years (range 6 months-7.7 years), with an actuarial survival of 82% at 7 years. At latest follow-up, no patient showed signs of cardiac or neurologic dysfunction. The present experience shows that a strategy of selective and independent cerebro-myocardial perfusion is safe, versatile, and feasible in high-risk neonates with complex congenital arch pathology. Encouraging outcomes were noted in terms of cardiac and neurological function, with limited end-organ morbidity., (© 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Published
2018
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29. Twenty-Year Outcome After Right Ventricular Outflow Tract Repair Using Heterotopic Pulmonary Conduits in Infants and Children.

Author

Hoxha S, Torre S, Rungatscher A, Sandrini C, Rossetti L, Barozzi L, Faggian G, and Luciani GB

Subjects
Adolescent, Blood Vessel Prosthesis Implantation adverse effects, Blood Vessel Prosthesis Implantation mortality, Child, Child, Preschool, Female, Graft Survival, Heart Defects, Congenital diagnosis, Heart Defects, Congenital mortality, Heart Defects, Congenital physiopathology, Hospital Mortality, Humans, Infant, Infant, Newborn, Kaplan-Meier Estimate, Male, Prosthesis Failure, Pulmonary Artery physiopathology, Reoperation, Retrospective Studies, Risk Factors, Time Factors, Transplantation, Heterologous, Transplantation, Heterotopic, Treatment Outcome, Bioprosthesis, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Heart Defects, Congenital surgery, Pulmonary Artery transplantation
Abstract

Durability of pulmonary conduits (PCs) used for reconstruction of the right ventricular outflow tract (RVOT) may be affected by a variety of factors. Among these, the technique used for PC implantation, whether in orthotopic or heterotopic position, strictly dependent upon the underlying anatomy, has been suggested to influence long-term outcome after RVOT repair. To determine the outcome of heterotopic implantation in infants and children treated at our institution, late results of heterotopic PC in non-Ross patients were analyzed and compared with data of orthotopic PC in age-matched pediatric Ross patients operated during the same time period. Between November 1991 and January 2015, 58 infants and children, 32 male and 26 female, with a median age of 9.4 years (range 1 day-18 years) underwent implantation of heterotopic PC (31 homografts [HG] and 27 xenografts [XG]) for reconstruction of RVOT. Median age in the XG group was significantly lower than in the HG group (0.9 vs. 13.4 years, P = 0.01), while male/female ratio was similar. Fifty (86%) patients had undergone one or more prior cardiac operations, while 32 (55%) required associated procedures during PC implantation. Comparison with data in 305 children and with a median age of 9.4 years, receiving orthotopic PC between 1990 and 2012 (Italian Pediatric Ross Registry), was undertaken. Descriptive, univariate, and Kaplan-Meier analysis defined outcome. There were three (5.2%) early and five (9.0%) late deaths, during a median follow-up of 7.6 years (range 2 months-23 years). Patients having XG had trend toward higher hospital mortality (2/27 vs. 1/31, P = 0.2), but similar late mortality (2/24 vs. 3/30, P = 0.3). Overall survival was 88 and 62%, while freedom from PC replacement was 49 and 21%, at 10 and 20 years, respectively. The latter proved significantly worse than freedom from orthotopic PC replacement, which was 94 ± 2 and 70 ± 9% at 10 and 20 years (P = 0.02). When stratified for type of heterotopic PC, late survival proved comparable (81 and 81% for XG vs. 92 and 60% for HG, at 10 and 20 years, respectively, P = 0.7). However, freedom from PC replacement was significantly higher in patients with heterotopic HG (21 and 5% for XG vs. 63 and 48% for HG, at 10 and 20 years, respectively, P = 0.001). RVOT repair using either XG or HG in heterotopic position is a safe procedure associated with low hospital mortality and satisfactory late survival. Freedom from reoperation is significantly lower than that observed in age-matched children having orthotopic HG. Freedom from reoperation in heterotopic XG is poorer than in HG, although different baseline demography may have influenced this finding., (Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Published
2016
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