Role of 256 slice CT scan in pre and postoperative evaluation of congenital cardio-vascular anomalies: our experience at a tertiary care teaching hospital
DOI:
https://doi.org/10.18203/2349-3933.ijam20170424Keywords:
Congenital cardiovascular anomalies, Cardiac CT angiography, Ultrafast CT scanAbstract
Background: Ultrafast CT (UCT) scan plays an important role in the evaluation of congenital cardiovascular anomalies (CCVA). A major advantage of higher slice multi-detector CT (MDCT), is improved temporal as well as spatial resolution, that helps accurately to delineate complex cardiac and extra-cardiac anomalies with relative ease. Hence this study was aimed to highlight the utility of UCT in the evaluation of congenital cardiovascular anomalies in a large series of patients.
Methods: All consecutive patients with suspected CCVA were evaluated by cardiac CT angiography (CCTA) on 256 slice CT scan in a multispecialty tertiary care teaching institute from June 2013 to December2015.
Results: A total of 160 cases of CCVA were evaluated by CCTA. 50 patients had multiple anomalies. A total of 216 anomalies were diagnosed. Tetralogy of fallot (TOF) dominated the list of CCVAs (60, 28%) than the other abnormalities. Of them, 25 patients underwent Blalock Taussig (BT) shunt surgeries, 20 patients underwent total repair operation like Rastelli’s operation or augmentation of pulmonary arteries (PAs) while 15 patients were lost to follow up. Most of the patients diagnosed with CCVAs were managed successfully based on the imaging diagnosis of the cardiovascular anomaly.
Conclusions: Ultrafast CT scans have immense role in the evaluation of various types of congenital cardiovascular anomalies. It is particularly helpful in the evaluation of extra-cardiac systemic and pulmonary arterial and venous system, postoperative complications, to see the status of shunts, stents and conduits.
References
Marelli AJ, Mackie AS, Ionescu-Ittu R, Rahme E, Pilote L. Congenital Heart Disease in the General Population: Changing Prevalence and Age Distribution. Circulation. 2007;115:163-72.
Ntsinjana HN, Hughes ML, Taylor AM. The Role of Cardiovascular Magnetic Resonance in Pediatric Congenital Heart Disease. J Cardiovascular Mag Resonance. 2011;13:51.
Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, et al. Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr. 2006;19:1413-30.
Leschka S, Oechslin E, Husmann L, Desbiolles L, Marincek B, Genoni M, et al. Pre- and postoperative evaluation of congenital heart disease in children and adults with 64-section CT. RadioGraph. 2007;27:829-46.
Lock JLKJ, Perry SB. Diagnostic and Interventional Catheterisation in Congenital Heart Disease. 2nd edition. Springer; 1999.
Hollingsworth CL, Yoshizumi TT, Frush DP, Chan FP, Toncheva G, Nguyen G, et al. Pediatric cardiac-gated CT angiography: assessment of radiation dose. Am J Roentgenol. 2007;189:12-8.
Mehta R, Lee KJ, Chaturvedi R, Benson L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv. 2008;72:278-85.
Gaca AM, Jaggers JJ, Dudley LT, Bisset GS 3rd. Repair of congenital heart disease: a primer. Part 1. Radiol. 2008;247:617-31.
Dillman JR, Hernandez RJ. Role of CT in the Evaluation of Congenital Cardiovascular Disease in Children. Am J Roentgenol. 2009;192(5):1219-31.
Kilner PJ, Geva T, Kaemmerer H, Trindade PT, Schwitter J, Webb GD. Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology. Eur Heart J. 2010;31:794-805.
Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American college of cardiology/American heart association task force on practice guidelines (ACC/AHA/ASE committee to update the 1997 guidelines for the clinical application of echocardiography). J Am Coll Cardiol. 2003;42:954-70.
Taylor AM. Cardiac imaging: MR or CT? Which to use when. Pediatr Radiol. 2008;38(3):433-8.
Gilkeson RC, Ciancibello L, Zahka K. Multidetector CT evaluation of congenital heart disease in pediatric and adult patients. Am J Roentgenol 2003;180:973-80.
Chen ML, Lo HS, Su HY, Chao IM. Coronary artery fistula: assessment with multidetector computed tomography and stress myocardial single photon emission computed tomography. Clin Nucl Med. 2009;34(2):96-8.
Gaca AM, Jaggers JJ, Dudley LT, Bisset GS 3rd. Repair of congenital heart disease: a primer. Part 2 Radiology 2008; 248:44-60
Greil GF, Schoebinger M, Kuettner A, Schaefer JF, Dammann F, Claussen CD, et al. Imaging of aortopulmonary collateral arteries with high-resolution multidetector CT. Pediatr Radiol. 2006;36:502-9.
Goo HW, Park IS, Ko JK, Park IS, Yoon CH, Hopkins KL, et al. CT of congenital heart disease: normal anatomy and typical pathologic conditions. RadioGraph. 2003;23:147-65.
Lee T, Tsai IC, Fu YC, Jan SL, Wang CC, Chang Y, et al. Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility. Pediatr Radiol. 2006;36:1273-82.
Ley S, Zaporozhan J, Arnold R, Eichhorn J, Schenk JP, Ulmer H, et al. Preoperative assessment and follow-up of congenital abnormalities of the pulmonary arteries using CT and MRI. Eur Radiol. 2007;17:151-62.
Dashottar S, Singh AK, Suhag V, Sunita BS, Singh RK. Unusual Case of Congenital Aneurysm of Proximal Pulmonary Artery Causing Lung Collapse. J Cardiovas Dis Res. 2015;6(1):31-6.
RyersonL, Harder J. Totally anomalous pulmonary venous return. Cardiol Young. 2005;15:304–5.
Yang DH, Goo HW, Seo DM, Yun TJ, Park JJ, Park IS, et al. Multislice CT angiography of interrupted aortic arch. Pediatr Radiol. 2008;38:89-100.
Shih MC, Tholpady A, Kramer CM, Sydnor MK, Hagspiel KD. Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. Am J Roentgenol. 2006;187:788.
Sparrow P, Merchant N, Provost Y, Doyle D, Nguyen E, Paul N. Cardiac MRI and CT features of inheritable and congenital conditions associated with sudden cardiac death. Eur Radiol. 2009;19:259-70.
Schmitt R, Froehner S, Brunn J, Wagner M, Brunner H, Cherevatyy O, et al. Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography. Eur Radiol. 2005;15:1110-21.
