Detection of caval obstruction by magnetic resonance imaging after intraatrial repair of XXXX .

@entity1 @entity3886 @entity4264 @entity432
Vena caval obstruction may cause significant morbidity after intraatrial repair of @entity3886 ( @entity3886 ). Two noninvasive methods of diagnosing vena caval obstruction were compared with cardiac catheterization. Echocardiographically gated magnetic resonance imaging (MRI) and echocardiographic evaluation (2-dimensional saline contrast echocardiography and pulsed Doppler flow measurement) were performed on 15 @entity1 0.7 to 13.5 years after intraatrial repair of @entity3886 (8 Mustard, 7 Senning). At catheterization, complete superior vena cava or partial caval obstruction (gradient greater than 5 mm Hg from cava to systemic venous atrium) was present in 7 of 15 @entity1 . @entity4264 was directly visualized by MRI in both @entity1 with catheterization-proved complete superior @entity432 . A dilated azygous/hemiazygous venous complex (greater than or equal to 5 mm cross-sectional diameter) was seen by MRI in 5 of 7 @entity1 with complex or partial vena caval obstruction and in no @entity1 without vena caval obstruction. MRI showed superior vena caval dilatation (ratio of superior vena caval diameter to aortic diameter greater than 1.45) in 3 of 5 @entity1 with partial vena caval obstruction and in 0 of 8 without vena caval obstruction. Direct visualization of narrowing within the atrium was unreliable for any MRI plane because of the 3-dimensional nature of the intraatrial baffle. Two-dimensional saline contrast echocardiography, successfully performed in 12 of 15 @entity1 , detected complete superior vena caval obstruction only in the 2 @entity1 with catheterization-proved complete superior @entity432 . Contrast echocardiography failed to identify any of the 5 @entity1 with partial vena caval obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
