Direct identification of patency achieved by a bi-directional Glenn shunt procedure - Images by volume rendering using electron-beam computed tomography

Abstract

The present study aimed to identify the patency achieved by a bi-directional Glenn shunt procedure by shaded volume rendering (VR) images using electron-beam computed tomography (EBCT). A Damus Kay-Stanzel type procedure was performed on a female with hypoplastic left heart syndrome who later received a bi-directional Glenn shunt to increase pulmonary blood flow. In considering the characteristics of the bi-directional Glenn shunt procedure, in which the superior vena cava is connected to the right pulmonary artery, an early phase acquisition protocol with injection of contrast material from the right cubital vein using the step volume scan mode of EBCT was planned to acquire blood flow information. Excellent spatial resolution volume data of the heart and great vessels was obtained from which 3-dimensional images were made. Bi-directional Glenn shunt flow could be observed directly and the complex morphology and relationships between adjacent structures were revealed by 3-dimensional VR imaging. The combination of EBCT and VR can provide useful information to evaluate congenital heart diseases.