1522, either, cat: 49
THE IMPACT OF NON-INVASIVE MAGNETIC RESONANCE IMAGING
ON PEDIATRIC CARDIAC CARE
E.L. Heathfield1, T. Hussain1,2, S. Qureshi2, T. Witter2, A. Bell2, P. Beerbaum1,2,
R. Razavi1,2, G.F. Greil1,2
1
King’s College London BHF Centre, Division of Imaging Science, Biomedical
Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, 2Department of
Pediatric Cardiology, Evelina Children’s Hospital, Guy’s and St. Thomas’ NHS
Foundation Trust, London, UK
Aims/Background: Improvements in MRI for congenital heart disease has resulted in
fewer diagnostic catheter procedures. This study explores the impact that this has had
on pediatric cardiac care.
Methods: Children at our institution from 2005-10 undergoing elective diagnostic
cardiac catheterization or MRI are included. Indication, length of stay and
complications were recorded. In cases used to plan surgery, the 30-day survival was
recorded.
Results: For catheterizations (50 patients, (31 male, mean age 5.88 years, range 0-18)
all under general anaesthesia (GA)), the average stay in hospital was 1.32 days and
complications occurred in 11(22.0%). The average hospital stay for MRI (846
patients, (517 male, mean age 4.88 years, range 0-18 & 731 under GA)) was
significantly shorter 0.55 days (p<0.001), with fewer complications (16 (1.9%),
p=0.001). 24 catheter and 283 MRI patients underwent surgery within 18 months. 1
catheter patient (2.0%) and 4 MRI patients (1.4%) died within 30 days (p=0.8).
Common remaining indications for diagnostic catheterization included imaging of
major aorto-pulmonary collateral arteries and native pulmonary arteries in cases of
pulmonary atresia with VSD, imaging for coronary stenoses in Kawasaki disease and
where MRI was inadequate or contraindicated due to implanted devices.
Conclusions: Replacing catheterization with cardiovascular MRI in children has
resulted in reduced rates of complication, hospital stay, and use of anaesthesia without
impact on surgical outcomes. Remaining diagnostic catheters are performed in more
complex cases and have inherently more complications. This study highlights those
areas to direct future non-invasive imaging research to reduce catheterization rates
further.