News | Pediatric Imaging | July 20, 2016

New Guideline Addresses Multimodality Imaging for Complex Childhood Heart Disease

Experts from three societies share recommendations on diagnostic imaging procedures for patients with transposition of the great arteries

ASE, SCCT, SCMR, guideline, multimodality imaging, transposition of the great arteries, TGA

July 20, 2016 — At the end of June, experts from three different medical societies released a new guideline to help optimize lifetime management of patients with transposition of the great arteries, a congenital heart defect, both before and after surgical intervention.

Experts from the American Society of Echocardiography (ASE), in collaboration with the Society for Cardiovascular Magnetic Resonance (SCMR) and the Society of Cardiovascular Computed Tomography (SCCT), reviewed and analyzed a wide variety of scientific evidence, resulting in recommendations for optimal multimodality image monitoring for these patients.

The writing group for this new guideline, titled Multimodality Imaging Guidelines of Patients With Transposition of the Great Arteries, was co-chaired by Meryl S. Cohen, M.D., FASE, from The Children’s Hospital of Philadelphia, and Benjamin W. Eidem, M.D., FASE, of Mayo Clinic in Rochester, Minn. When asked about the need for this new guideline, Cohen commented, “Transposition of the Great Arteries (TGA) is the second most common cyanotic (low oxygen level in the blood seen as blue-tinged lips and nailbeds) congenital heart defect, with more than 1,200 babies born each year in the United States alone. Advances in the diagnosis and management of congenital heart disease have led to a marked improvement in survival of patients with TGA since it was first surgically palliated in the 1950s. However, ongoing anatomic and hemodynamic abnormalities are nearly universal in patients with repaired TGA, necessitating a lifetime of follow-up cardiac care.”

Diagnostic imaging — including echocardiography, cardiovascular magnetic resonance (CMR), cardiovascular computed tomography (CCT) and X-ray angiography — plays a significant role in identifying any abnormalities and assessing their severity, to help cardiologists make clinical decisions about how to best manage these issues. The aims of this document are to describe the role of each diagnostic modality in the care of both preoperative and postoperative TGA patients, and to provide guidelines for a multimodality approach that takes into account various patient- and modality-related considerations. The document also contains over 50 figures, 10 tables and 24 videos, which include imaging protocols, strategies for overall evaluation, reporting recommendations and imaging examples.

Cohen elaborated on the complexity of the issue, stating, “While echocardiography provides the ability to evaluate the majority of anatomic and hemodynamic abnormalities, especially prior to corrective surgery, other modalities such as CMR and CT often provide additional information to answer particular clinical questions, such as right heart size and function, coronary artery abnormalities and perfusion imaging. Patients with TGA are surviving into adulthood, thus various imaging strategies are important over the lifetime of these patients. Clinicians are faced with the challenge of how to best evaluate these patients in a way that minimizes invasiveness, risk and cost while providing the best diagnostic information. This document provides a roadmap for making these decisions.”

In conjunction with the guideline document, Cohen will conduct a live webinar in September 2016 including a question and answer section, which will be available for free to all ASE members and open to all other clinicians for a fee of $25.

The full guideline document is now available on the Journal of American Society of Echocardiography (JASE) website and will be published in the July 2016 print issue.

For more information: www.asecho.org

Related Content

Improved Imaging Technique Could Increase Chances of Prostate Cancer Survival
News | Prostate Cancer | August 20, 2019
According to the American Cancer Society, approximately one in nine men will be diagnosed with prostate cancer in their...
ADHD Medication May Affect Brain Development in Children

Images of regions of interest (colored lines) in the white matter skeleton representation. Data from left and right anterior thalamic radiation (ATR) were averaged. Image courtesy of C. Bouziane et al.

News | Neuro Imaging | August 16, 2019
A drug used to treat attention-deficit/hyperactivity disorder (ADHD) appears to affect development of the brain’s...
Profound Medical Receives U.S. FDA 510(k) Clearance for Tulsa-Pro
Technology | Interventional Radiology | August 16, 2019
Profound Medical Corp. announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) to...
Contrast Use in First Transthoracic Echocardiogram for Heart Failure Reduces Repeat Testing
News | Cardiovascular Ultrasound | August 07, 2019
Heart failure is the fourth most common cause for all admission to U.S. hospitals, and it is the most common reason for...
Digital Health Devices Used at Point of Care May Improve Diagnostic Certainty
News | Cardiovascular Ultrasound | August 05, 2019
A West Virginia-based rural medical outreach event showcased the use of point-of-care technology in an ambulatory...
Studies Confirm Clinical Value of ShearWave Elastography for Liver Fibrosis Evaluation
News | Ultrasound Imaging | July 31, 2019
SuperSonic Imagine announced the publication of the results of its prospective multicentric clinical study conducted in...
Intelligent Ultrasound Group Collaborating With the National Imaging Academy Wales

The ScanTrainer transvaginal simulator is one example of Intelligent Ultrasound's simulation technologies.

News | Ultrasound Imaging | July 26, 2019
Artificial intelligence (AI)-based ultrasound software and simulation company Intelligent Ultrasound Group plc (AIM:...
FDA Clears Koios DS Breast 2.0 AI-based Software
News | Ultrasound Women's Health | July 11, 2019
Koios Medical announced its second 510(k) clearance from the U.S. Food and Drug Administration (FDA).
360 Photos | Ultrasound Imaging | July 11, 2019
This 360 degree photo shows a basic, point-of-care cardiac echocardiogram being performed using a smartphone turned i