Author: Prof. Berger, Dr. Ewert

German Heart Center Berlin, Germany

Patient History

5-year-old male (20 kg) with Hypoplastic Heart Syndrome; pre-Fontan surgery evaluation.

Diagnosis

syngo DynaCT Cardiac demonstrated visualization of the pulmonary vasculature and the cavopulmonary anastomosis. The 3D images confirmed the stent position within a patent pulmonary artery. The patient was mildly sedated and the syngo DynaCT images were acquired during normal respiration.

Protocol

5 sec rotational angiography, 130 projection images. 
Injection: 20 cc contrast, 60 cc total volume (dilution 1:2), injection rate 10 ml/sec, 1 sec X-ray delay.

Treatment/ Imaging

Imaging has been performed while patient was slightly sedated without breathhold. Goal of the 3D imaging was visualization of the whole lung vessel tree and of the stent. 3D image was helpful for determining further treatment.

Comments

This was the first worldwide pediatric case with syngo DynaCT Cardiac. The excellent three-dimensional visualization of the pulmonary tree versus the whole lung vessel tree is comparable to conventional CT imaging with significantly reduced radiation exposure. syngo DynaCT Cardiac images provided optimal image projections to aid in the successful treatment planning and intervention.

Fig 1: Three-dimensional reconstruction of the superior caval vein, the bidirectional Glenn-anastomosis and the pulmonary arterial vessels. A stent is visible in the central pulmonary arteries. 
(Ewert, DHZB, German Heart Institute Berlin) 

Movie clip: The 3D images confirmed the stent position within a patent pulmonary artery. 
(Ewert, DHZB, German Heart Institute Berlin)

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