Optical coherence tomography of the pulmonary arteries in children with congenital heart diseases: A systematic review

IMPORTANCE: Optical coherence tomography (OCT) is a high‐resolution intravascular imaging tool and has shown promise for providing real‐time quantitative and qualitative descriptions of pulmonary vascular structures in vivo in adult pulmonary hypertension (PH), while not popular in pediatric patients with congenital heart diseases (CHD). OBJECTIVE: The aim of this review is to summarize all the available evidence on the use of OCT for imaging pulmonary vascular remodeling in pediatric patients. METHODS: We conducted the systematic literature resources (Cochran Library database, Medline via PubMed, EMBASE, and Web of Knowledge) from January 2010 to December 2021 and the search terms were “PH”, “child”, “children”, “pediatric”, “OCT”, “CHD”, “pulmonary vessels”, “pulmonary artery wall”. Studies in which OCT was used to image the pulmonary vessels in pediatric patients with CHD were considered for inclusion. RESULTS: Five studies met the inclusion criteria. These five papers discussed the study of OCT in the pulmonary vasculature of different types of CHD, including common simple CHD, complex cyanotic CHD, and Williams‐Beuren syndrome. In biventricular anatomy, pulmonary vascular remodeling was primarily reflected by pulmonary intima thickening from two‐dimensional OCT. In single‐ventricle anatomy, due to the state of hypoxia, the morphology of pulmonary vessels was indirectly reflected by the number and shape of nourishing vessels from three‐dimensional OCT. INTERPRETATION: OCT may be an adequate imaging procedure for the demonstration of pulmonary vascular structures and provide additional information in pediatric patients.