Cardiac magnetic resonance imaging prior to bidirectional cavopulmonary connection in hypoplastic left heart syndrome

Abstract

Background: Recent evidence has suggested that haemodynamic information obtained from cardiac catheterisation is not essential in pre-operative assessment of children with hypoplastic left heart syndrome (HLHS) undergoing Bidirectional Cavopulmonary Connection (BCPC). Therefore our unit changed to cardiac Magnetic Resonance Imaging (MRI) in 2006. We aimed to compare peri-operative outcomes before and after this change.

Methods: Children with HLHS who underwent BCPC between 2004 and 2008 were identified. Data were collected regarding pre-operative findings and peri-operative outcomes.

Results: Forty patients were identified-catheterisation (n=21), MRI (n=19). Catheterisation patients were older at the time of BCPC (114.9+/-22.7 days vs. 95.4+/-11 days: p value 0.002), with no other differences in baseline data. Two patients required cardiopulmonary resuscitation during catheterisation; with no adverse events during MRI. Cardiopulmonary bypass time, ventilation time, inotrope score, and intensive care unit stay were similar. Length of hospital stay and oxygen saturations at discharge were also not significantly different.

Conclusions: We have demonstrated that post-operative course and outcomes are similar in patients with HLHS who had MRI or catheterisation as their pre-BCPC investigation. Additionally the complementary data provided by echocardiography and MRI safely provides sufficient anatomic and functional information with which to plan the BCPC.