Three-dimensional imaging of aortic arch anomalies in infants and childrenwith intravascular ultrasound catheters from a transesophageal approach

Aortic arch anomalies usually require surgical intervention preceded by pre cise anatomic definition. We studied 20 patients to evaluate the feasibilit y and accuracy of using intravascular ultrasound catheters from a transesop hageal approach with 3-dimensional image reconstruction for the diagnosis o f aortic arch anomalies in Infants and children. All patients had transthor acic echocardiograms and/or angiograms or magnetic resonance imaging. A 12. 5-MHz intravascular ultrasound catheter was positioned in the esophagus and withdrawn by using an electrocardiogram and a respiratory gated pullback d evice to acquire the mediastinal images. All patients with arch anomalies u nderwent surgical repair. Reconstructed images were analyzed in the "anypla ne" mode and with surface rendering. Intravascular ultrasound 3-dimensional imaging was successfully accomplished without complications. Anatomy was c orrectly identified in all patients by both blinded and unblinded observers , thus confirming the sensitivity and accuracy of the technique. We foresee this new technique to be useful as an adjunctive imaging modality applicab le at the bedside or in the cardiac imaging laboratory.