Single ventricle patients typically undergo some form of advanced diagnostic imaging prior to superior cavopulmonary connection (SCPC). We sought to evaluate variability of diagnostic practice and associated comprehensive risk. A retrospective evaluation across 4 institutions was performed (1/1/2010-9/30/2016) comparing the primary modalities of cardiac catheterization (CC), cardiac magnetic resonance (CMR), and cardiac computed tomography (CT). Associated risks included anesthesia/sedation, vascular access, total room time, contrast agent usage, radiation exposure, and adverse events (AEs). Of 617 patients undergoing SCPC, 409 (66%) underwent at least one advanced diagnostic imaging study in the 60 days prior to surgery. Seventy-eight of these patients (13%) were analyzed separately because of a concomitant cardiac intervention during CC. Of 331 (54%) with advanced imaging and without catheterization intervention, diagnostic CC was most common (59%), followed by CT (27%) and CMR (14%). Primary modality varied significantly by institution (p < 0.001). Median time between imaging and SCPC was 13 days (IQR 3-33). Anesthesia/sedation varied significantly (p < 0.001). Pre-procedural vascular access did not vary significantly across modalities (p = 0.111); procedural access varied between CMR/CT and CC, in which central access was used in all procedures. Effective radiation dose was significantly higher for CC than CT (p < 0.001). AE rate varied significantly, with 12% CC, 6% CMR, and 1% CT (p = 0.004). There is significant practice variability in the use of advanced diagnostic imaging prior to SCPC, with important differences in associated procedural risk. Future studies to identify differences in diagnostic accuracy and long-term outcomes are warranted to optimize diagnostic protocols.

中文翻译：

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高级腔静脉肺连接之前的高级诊断成像实践模式和相关风险的变化：多中心分析。

单心室患者通常在上腔静脉肺连接 (SCPC) 之前接受某种形式的高级诊断成像。我们试图评估诊断实践的可变性和相关的综合风险。对 4 个机构进行了回顾性评估（2010 年 1 月 1 日至 2016 年 9 月 30 日），比较了心脏导管插入术 (CC)、心脏磁共振 (CMR) 和心脏计算机断层扫描 (CT) 的主要方式。相关风险包括麻醉/镇静、血管通路、总房间时间、造影剂使用、辐射暴露和不良事件 (AE)。在接受 SCPC 的 617 名患者中，409 名 (66%) 在手术前 60 天内接受了至少一项高级诊断成像研究。由于 CC 期间伴随的心脏干预，这些患者中有 78 名（13%）被单独分析。在 331 例 (54%) 具有先进成像且无导管介入治疗的患者中，诊断性 CC 最常见 (59%)，其次是 CT (27%) 和 CMR (14%)。主要方式因机构而异（p < 0.001）。成像和 SCPC 之间的中位时间为 13 天 (IQR 3-33)。麻醉/镇静有显着差异（p < 0.001）。不同方式的术前血管通路没有显着差异（p = 0.111）；CMR/CT 和 CC 之间的程序访问不同，其中所有程序都使用中央访问。CC 的有效辐射剂量显着高于 CT (p < 0.001)。AE 率差异显着，CC 为 12%，CMR 为 6%，CT 为 1%（p = 0.004）。在 SCPC 之前使用高级诊断成像存在显着的实践差异，在相关的程序风险方面存在重要差异。