Organisation of paediatric echocardiography laboratories and governance of echocardiography services and training in Europe: current status, disparities, and potential solutions. A survey from the Association for European Paediatric and Congenital Cardiology (AEPC) imaging working group.

Background: There is limited data on the organisation of paediatric echocardiography laboratories in Europe.

Methods: A structured and approved questionnaire was circulated across all 95 Association for European Paediatric and Congenital Cardiology affiliated centres. The aims were to evaluate: (1) facilities in paediatric echocardiography laboratories across Europe, (2) accredited laboratories, (3) medical/paramedical staff employed, (4) time for echocardiographic studies and reporting, and (5) training, teaching, quality improvement, and research programs.

Quantitative evaluation of aortic valve regurgitation in 4D flow cardiac magnetic resonance: at which level should we measure?

Purpose: To find the best level to measure aortic flow for quantification of aortic regurgitation (AR) in 4D flow CMR.

Methods: In 27 congenital heart disease patients with AR (67% male, 31 ± 16 years) two blinded observers measured antegrade, retrograde, net aortic flow volumes and regurgitant fractions at 6 levels in 4D flow: (1) below the aortic valve (AV), (2) at the AV, (3) at the aortic sinus, (4) at the sinotubular junction, (5) at the level of the pulmonary arteries (PA) and (6) below the brachiocephalic trunk. 2D phase contrast (2DPC) sequences were acquired at the level of PA.

Accuracy of Cardiac Magnetic Resonance Imaging in Diagnosing Pediatric Cardiac Masses: A Multicenter Study.

Background: After diagnosis of a cardiac mass, clinicians must weigh the benefits and risks of ascertaining a tissue diagnosis. Limited data are available on the accuracy of previously developed noninvasive pediatric cardiac magnetic resonance (CMR)-based diagnostic criteria.

Objectives: The goals of this study were to: 1) evaluate the CMR characteristics of pediatric cardiac masses from a large international cohort; 2) test the accuracy of previously developed CMR-based diagnostic criteria; and 3) expand diagnostic criteria using new information.

In vivo MRI measurement of blood oxygen saturation in children with congenital heart disease.

Objective: The purpose of this prospective study was to measure in vivo blood oxygen saturation (%O2) by MRI in children with congenital heart disease (CHD) using population-based values for T2O (T2 signal decay of fully oxygenated blood) and K (a parameter representing the deoxyhemoglobin effect) and compare the %O2 with direct cardiac catheterization measurements.

Background: MRI can determine %O2 using in vivo measurement of signal decay (T2) and an in vitro calibration curve relating T2 and %O2, based on the equation: 1/T2 = 1/T2O + K(1-%O2/100)2. Recent studies have correlated the T2/%O2 in children with CHD with the adult calibration statistics.

Phase-contrast MR assessment of pulmonary venous blood flow in children with surgically repaired pulmonary veins.

Background: Pulmonary venous (PV) obstruction may complicate surgical repair of PV abnormalities. By combining phase-contrast cine (PC) imaging and contrast-enhanced angiography, magnetic resonance (MR) imaging can provide physiological information complementing anatomical diagnosis. OBJECTIVES.

Differential regurgitation in branch pulmonary arteries after repair of tetralogy of Fallot: a phase-contrast cine magnetic resonance study.

Background: The importance of pulmonary regurgitation (PR) after repair of tetralogy of Fallot (TOF) is increasingly recognized, but little is known regarding its underlying mechanisms. This phase-contrast cine magnetic resonance (PC MR) study was performed to evaluate the relative contribution of each lung to total regurgitant volume.

Methods And Results: Twenty-two patients with significant PR underwent a PC MR 3 to 16 years after repair of TOF.

Contrast-enhanced MR angiography of pulmonary venous abnormalities in children.

Background: Echocardiography and X-ray angiography have been considered as gold standards for evaluation of pulmonary venous abnormalities. However, each technique has its own limitations, such as limitation in visualization of the pulmonary veins within the lungs by echocardiography, and the invasive nature of and use of ionizing radiation in X-ray angiography. Contrast-enhanced MR angiography (MRA) is a fast noninvasive method of visualization of the vessels including the pulmonary arteries and veins.

Assessment of the thymus at echocardiography in fetuses at risk for 22q11.2 deletion.

Objectives: An absent or hypoplastic thymus is common in patients with 22q11.2 deletion (del22q11.2).

Cardiac rhythm disturbances in children on hemodialysis.

Cardiovascular complications are the leading causes of morbidity and mortality in adult dialysis patients. The aim of this study was to evaluate the cardiovascular system of children on hemodialysis (HD), with special focus on rhythm disturbances. Nine patients, aged 15.

Early postoperative arrhythmias after cardiac operation in children.

Background: Arrhythmias are a recognized complication of cardiac operations. However, little is known about the incidence, treatment, and risk factors for early postoperative arrhythmias in children after cardiac operations.

Methods: Diagnosis and treatment of early postoperative arrhythmias were prospectively analyzed in an intensive care unit in 100 consecutive children with a median age of 17 months (range, 1 day to 191 months) who had undergone cardiac operation.

MRI-based blood oxygen saturation measurements in infants and children with congenital heart disease.

Background: Vessel oxygen saturation can be determined with MR oximetry using an in vivo measurement of signal decay (T2) and the calibration curve relating T2 to blood oxygen saturation (%HbO(2)), where: 1/T2=1/T2O+K (1-%HbO(2)/100)(2) and K is a constant parameter which correlates with measured fibrinogen levels. The ability to noninvasively measure %HbO(2) in cardiac chambers and vessels has enormous potential in children with congenital heart disease (CHD).

Objective: The purpose of the study was to prospectively characterize the T2-%HbO(2) relationship in infants where T2-%HbO(2) is the relationship between T2 and %HbO(2) (blood oxygen saturation) expressed by the equation given above, and to determine whether adult values for K and T2O (where T2O is the T2 of fully oxygenated blood) can be extrapolated to pediatric patients with CHD.