60    Congenital Heart Disease

MRI evaluation of congenital heart disease is a minimally invasive alternative to cardiac angiography, although sedation of uncooperative pediatric patients may be required. The most common congenital disorder of the heart is a bicuspid aortic valve of which aortic stenosis is the most frequent complication (see Chapter 59). Ventricular septal defects (VSD) are the second most common, their significance depending upon the size of and flow through the defect. Absent other shunting, comparison of pulmonary artery and aortic outflow (with velocity-encoded MRI) or left and right ventricular volumes (the right is normally larger with a VSD) allow quantification of shunt volume with MRI. The four-chamber cine image of Fig. 60.1A demonstrates a VSD of the muscular septum—as opposed to the more common membranous defect—and resulting right ventricular hypertrophy. A low SI jet into the left ventricle identifies the reversal of normal left to right flow across the defect, corresponding with an Eisenmenger-type physiology. Atrial septal defects (ASDs) are classified as secundum, arising from a defect in the fossa ovale, and less common primum types, arising from sinus venosus defects. ASD in association with a cleft of the anterior mitral leaflet occurs in a partial or complete arteriovenous canal.

Related posts:

Multiple Sclerosis Disorders of Marrow Disk Herniations Other Inflammatory/Infectious Diseases Common Incidental Findings Adrenal Disease

Stay updated, free articles. Join our Telegram channel

Join