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Right Ventricular Anomalies

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Magnetic Resonance Imaging of Congenital Heart Disease

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Abstract

The advantages of cardiovascular magnetic resonance (CMR) imaging for static and dynamic characterization of the right ventricle are increasingly being realized. The advantages are even more pronounced when imaging the right ventricle affected by congenital malformation, in every age group.

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Author information

Authors and Affiliations

  1. Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children NHS Trust, London, UK

    Frédérique Bailliard M.D., M.S. & Marina L. Hughes DPhil, MRCP, FRACP

  2. Bailliard Henry Pediatric Cardiology, 2304 Wesvill Court, Raleigh, NC, 27607, USA

    Frédérique Bailliard M.D., M.S.

  3. Cardiorespiratory Unit, Great Ormond Street Hospital for Children Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK

    Marina L. Hughes DPhil, MRCP, FRACP

Authors
  1. Frédérique Bailliard M.D., M.S.
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  2. Marina L. Hughes DPhil, MRCP, FRACP
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Corresponding author

Correspondence to Frédérique Bailliard M.D., M.S. .

Editor information

Editors and Affiliations

  1. , Stritch School of Medicine, Loyola University Chicago, S. First Ave. 2160, Maywood, 60153, Illinois, USA

    Mushabbar A. Syed

  2. Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom

    Raad H. Mohiaddin

6.1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

This is raw, isotropic, 3D data in the coronal plane, from the first pass of a MR angiogram, triggered when contrast fills the left heart. The patient is an infant with complex double outlet RV, subpulmonary VSD, left aortic arch, with aberrant left subclavian artery and coarctation aorta. The patient initially underwent coarctation repair and PA banding, and subsequently underwent arterial switch procedure, involving the Le Compte maneuver, PA debanding and VSD closure. This data clearly demonstrates severe, long-segment, tubular narrowing of the proximal left pulmonary artery, significant dilatation of the neo-aortic root and a tortuous aortic arch, with mild residual coarctation (MOV 6782 KB)

Movie 6.2

This is a 360-degree rotational movie, made from the 3D volume-rendered data from the patient described above (MOV 699 KB)

A segmented, bSSFP cine, showing a skewed sagittal view of the right ventricle that includes both inflow and outflow tracts. This adult patient has unoperated, double-chambered right ventricle, associated with a perimembranous ventricular septal defect. Persistent, native, septo-parietal fibromuscular bands occupy a high horizontal position, proximal to the infundibular region, and give rise to dynamic obstruction. The level of the obstruction is shown with a white arrow, the level of the pulmonary valve is shown with a black arrow. The unobstructed infundibular region lies between these levels (see also Fig. 6.3) (MOV 635 KB)

A pair of segmented bSSFP cines from the same patient in Fig. 6.3a and Movie 6.3, with the slice reference position of the axial plane (the left-hand image) shown on the right-hand skewed, sagittal image. The axially orientated image demonstrates the network of obstructive fibromuscular bands and the relationship of these to the perimembranous VSD (MOV 893 KB)

A segmented, bSSFP cine image in the short axis plane showing the obstructive, mid-ventricular, fibromuscular bands causing flow acceleration and turbulence towards the RV outflow tract. The flattened interventricular septal motion in systole suggests elevated systolic pressures in the proximal RV chamber. Poor ECG gating caused by occasional ventricular ectopic beats degrades the technical quality of this image (MOV 2217 KB)

A segmented, bSSFP cine, showing a 4-chamber view from an adult patient following “one and a half ventricle” repair of PA/IVS. This patient has a pulmonary valve homograft and a bidirectional cavopulmonary anastomosis. The right ventricle is hypoplastic with impaired systolic function (RV ejection fraction 47 %) and severe diastolic dysfunction. Note the sharp shift of the interventricular septum towards the left during diastole (see also Fig. 6.4) (MOV 2181 KB)

Movie 6.7

This is a segmented, breath-hold bSSFP cine view in the mid-ventricular short axis plane, from an 11-year-old patient with idiopathic pulmonary hypertension. There is severe hypertrophy and dilatation of the right ventricle. The right ventricular systolic function is globally, severely reduced. There is bowing of the septum towards the left ventricle throughout the cardiac cycle and interventricular dyssynchrony (see also Fig. 6.7) (MOV 1973 KB)

Movie 6.8

This is a segmented, breath-hold bSSFP cine, showing a sagittal view of the RV outflow tract, dilated MPA and proximal LPA from 16-year-old patient with Eisenmenger physiology, following chronic pulmonary overcirculation due to an ASD and a large muscular VSD. The spatial and temporal resolution of the image has been lowered to give a shorter breath-hold duration, because of the poor breath-holding capacity of the patient (see also Fig. 6.8) (MOV 1630 KB)

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Bailliard, F., Hughes, M.L. (2012). Right Ventricular Anomalies. In: Syed, M., Mohiaddin, R. (eds) Magnetic Resonance Imaging of Congenital Heart Disease. Springer, London. https://doi.org/10.1007/978-1-4471-4267-6_6

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