Imaging strategies of coarctation repairs

Background Coarctation is a common cardiovascular lesion accounting for 5 7% of all congenital heart disease. Without appropriate treatment complications are common and up to 90% of patients with uncorrected coarctation die by the age of 60. After repair close follow-up of patients is recommended. Recognised complications may include residual or recurrent coarctation and aneurysm formation. Follow up of associated aortic valve disease is also required. MRI is the preferred imaging modality for coarctation repairs as it provides anatomical and functional information without radiation exposure. It may also aid planning for further intervention or surgical treatment where necessary. Available sequences; Cine imagesSteady State Free Precession (SSFP) or Gradient Recalled Echo (GRE) sequences, providing anatomical and functional information. Black Blood Fast Spin Echo (FSE) provides good visualization of the vessel wall and is less susceptible to metal artefact and is therefore particularly useful following stenting. Magnetic Resonance Angiography (MRA) either Contrast Enhanced or Freebreathing ECG triggered, navigator-gated 3D segmented SSFP. Both provide a 3D volume of data. This may be reformatted to any plane. Phase Contrast imaging allows for assessment of blood flow and further physiological evaluation.