Comparison between transthoracic echocardiography and cardiac magnetic resonance imaging in patients status post atrial switch procedure

Jason G Ho, Mervyn D Cohen, Eric S Ebenroth, Marcus S Schamberger, Timothy M Cordes, Matthew T Bramlet, Roger A Hurwitz, Tiffanie R Johnson
Congenital Heart Disease 2012, 7 (2): 122-30

OBJECTIVES: This study compares image quality, cost, right ventricular ejection fraction analysis, and baffle visualization between transthoracic echocardiography and cardiac magnetic resonance imaging in those status post atrial switch for transposition of the great arteries.

BACKGROUND: This population requires imaging for serial evaluations. Transthoracic echocardiography is often first line but has drawbacks, many of which are addressed by cardiac magnetic resonance imaging.

METHODS: Twelve patients (mean age 25 years) with relatively concurrent (mean 157 days) studies were included. Three separate echocardiography and magnetic resonance imaging physicians independently analyzed baffles, image quality, and right ventricular ejection fractions. Institutional and Medicaid charges were compared.

RESULTS: For right ventricular ejection fraction, echocardiography (36.1%) underestimated cardiac magnetic resonance imaging (47.8%, P = .002). Image quality for transthoracic echocardiography was significantly rated lower than cardiac magnetic resonance imaging (P = .002). Baffles were better seen in cardiac magnetic resonance imaging (transthoracic echocardiography vs. cardiac magnetic resonance imaging: superior vena cava 86% vs. 100% [P = .063]; inferior vena cava 33% vs. 97% [P = .002]; pulmonary vein 92% vs. 100% [P = .250]). Comparing hospital charges and Medicaid reimbursement, transthoracic echocardiography respectively costs 18% and 38% less than cardiac magnetic resonance imaging.

CONCLUSIONS: In conclusion, transthoracic echocardiography underestimated right ventricular ejection fraction compared to cardiac magnetic resonance imaging. Cardiac magnetic resonance imaging had consistently higher image quality and better visualization of the baffles. Cost differences are minimal. We propose that cardiac magnetic resonance imaging be considered first line for imaging in certain patients' status post atrial switch procedure.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"