Assessment of 3D Imaging of the Aorta in Congenital Heart Disease in the Cardiac Catheterization Laboratory

Objective: Three-dimensional rotational angiography (3DRA) provides highly valuable 3D information. Especially extracardiac structures are displayed in high quality which results in key benefits, both in diagnostic and interventional settings. The aim of the study is to evaluate its clinical benefit.

Methods: In a retrospective study, approximately 62 cases of patients with abnormalities of the aorta were analyzed after examination in the cardiac catheterization laboratory between January 2010 and March 2013. Separation into two groups: one diagnostical (Group 1) and one interventional group (Group 2). Evaluation of image quality, accuracy, and comparative measurement between 3DRA and conventional biplane angiography. In addition, radiation dose, contrast dye, and fluoroscopy time were analyzed.

Results: Group 1: 18 cases and Group 2: 44 cases. The use of 3DRA was rated superior to conventional angiography in approximately 90%. Median consumption of contrast dye 4.0 mL/kg (0.1 – 13.11 mL/kg), median dose area product in total investigation 1,207.1µGym² (71.4 – 5,151.5µGym²). Median fluoroscopy time in Group 1: 8.2 minutes (0.5 – 42.1 min), in Group 2: 10.6 minutes (2.6 – 49.7 min) – significantly lower compared with a historical control group.

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Conclusion: 3D imaging of the aorta shows significant advance compared with the conventional angiography, it improves diagnostic accuracy and enables a safer and faster intervention with a potential to reduce radiation dose and contrast dye with enhanced patients' safeness.