Rotational Angiography and 3D Modeling in Diagnostics and Treatment of CHD

Abstract. Advances in the diagnosis and treatment of congenital heart defects are associated with development of visualization technics. 3D rotational angiocardiography (3D RA) is a relatively new and in the treatment of CHD number of publications is not very large, and there are still many unresolved issues.

Material and methods. From 2012 to 2015, in 150 patients with various CHD were performed 169 3D RA and compared with standard angiocardiography.

The patients were divided into 6 groups: pulmonary artery (n = 41), right ventricle outflow tract (n = 50), great veins (n ​​= 24), aorta (n = 21), abnormal communication between major vessels (n = 16), the left ventricular outflow tract (n = 17). The criteria for the comparative analysis have been visualization quality, additional information, the radiation dose, the amount of contrast agent during the study and study time.

Results. Resulted that 3D RA had visualization quality better than standard angiocardiography in patients with peripheral stenosis LA, bifurcation stenosis LA, pathology of RVOT, in patients with communications between the main arteries in 56% of cases; in patients with aneurysm of the right ventricular outflow tract, in patients with obstruction of the left ventricle outflow tracts and in patients with great veins examination.

Radiation dose during 3D RA was 503,4 ± 350 cGy / cm², while during standard angiocardiography - 820,8 ± 400 cGy / cm² (p = 0.036). Study duration was 14,1 ± 10 minutes using 3D RA and 15,1 ± 9 minutes using standard angiocardiography. The volume of used contrast agent was 49.9 ± 35 mL in 3D RA group and 47.8 ± 38 mL in standard angiocardiography, without significant difference.

3D RA contributed additional important information due to possibility to achieve three-dimensional models and obtain unlimited angulations.

Conclusion. 3D RA is high-quality and safe method of imaging of the heart and vessels in patients with a various CHD compared with standard angiocardiography. Using 3D RA often reveals important additional information about the anatomy area of examination.