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The arterial switch operation (ASO) for transposition of the great arteries (TGA) alters pulmonary artery (PA) geometry, resulting in abnormal flow hemodynamics and increased right ventricular (RV) afterload. This study integrated statistical shape modeling (SSM) and 4D flow cardiac magnetic resonance (CMR) imaging to evaluate PA shape and flow metrics in post-ASO patients. Compared to controls, the TGA shape template exhibited abnormal vessel caliper and curvature, and the overall cohort had elevated kinetic energy, viscous energy loss, and vorticity in the branch PAs. A shape mode (p4) was linked to worsening PA curvature, increased vorticity and elevated RV systolic pressures. Energy loss across the PAs also correlated with worsening RV systolic pressures. These findings underscore the role of comprehensive shape and flow assessment of PA geometry in monitoring long-term outcomes and optimizing current surgical strategies.

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Shape and Flow Characterization of the Pulmonary Arteries After the LeCompte Maneuver

  • 会议论文

  • 发表日期：

    2025年

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  • Jose Enzo Bunag,
  • Thomas Casto,
  • Tin The Phan,
  • Ryan O’Hara,
  • Yves d’Udekem,
  • Elias Balaras,
  • Francesco Capuano,
  • Yue-Hin Loke

摘要

The arterial switch operation (ASO) for transposition of the great arteries (TGA) alters pulmonary artery (PA) geometry, resulting in abnormal flow hemodynamics and increased right ventricular (RV) afterload. This study integrated statistical shape modeling (SSM) and 4D flow cardiac magnetic resonance (CMR) imaging to evaluate PA shape and flow metrics in post-ASO patients. Compared to controls, the TGA shape template exhibited abnormal vessel caliper and curvature, and the overall cohort had elevated kinetic energy, viscous energy loss, and vorticity in the branch PAs. A shape mode (p4) was linked to worsening PA curvature, increased vorticity and elevated RV systolic pressures. Energy loss across the PAs also correlated with worsening RV systolic pressures. These findings underscore the role of comprehensive shape and flow assessment of PA geometry in monitoring long-term outcomes and optimizing current surgical strategies.