Cardiovascular CT in Cyanotic Congenital Heart Disease

Chelliah, Anjali; Shah, Amee; Farooqi, Kanwal M.; Han, Bo

doi:10.1007/s12410-019-9507-3

Cited by 8 publications

(2 citation statements)

References 102 publications

(120 reference statements)

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“…While echocardiography remains the main diagnostic imaging modality, other imaging modalities, such as computed tomographic angiography, catheter angiography, or magnetic resonance imaging, are often performed for preoperative assessment (5). Computed tomographic angiography in particular, owing to its high spatial resolution, provides excellent visualization of both the cardiac and extracardiac anatomy (6)(7)(8)(9). Some time ago, we reported a patient whose right pulmonary artery was unusually compressed by a tortuous aorta.…”

Section: Introductionmentioning

confidence: 99%

Clarifying the anatomy of tetralogy of Fallot with S-shaped ascending aorta

Gupta,

Mukharjee,

Pandey

et al. 2024

Preprint

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BackgroundWe have recently encountered several cases of tetralogy of Fallot with an abnormally oriented S-shaped ascending aorta. In this retrospective study, we sought to clarify the morphology of this unusual under-recognized variant of tetralogy of Fallot.MethodsWe reviewed our databases to identify all patients with tetralogy of Fallot having an S-shaped ascending aorta. We then used computed tomographic angiography to make a detailed assessment of the cardiac morphology.ResultsOut of the 21 patients we identified, 18 (86%) had a right aortic arch, 2 (9%) had a left aortic arch, and the remaining patient (5%) had a double aortic arch. Patients with right aortic arch, compared to those with the normally oriented ascending aorta, had lesser aortic override (29.3±14% vs 54.8±13.2%; p=0.0001) and a wider ascending aorta (2.52±0.7 cm vs 1.80±0.32; p=0.0003). Overall, compared to normal cases, the ascending aorta was located posteriorly, with a higher sterno-aortic distance (2.55±0.8 cm vs 0.99±0.45 cm; p=0.0001). The ascending aorta was longer (4.12±1.7 vs 3.07±0.82, p=0.03) although the tortuosity index (1.22±0.19 vs 1.15±0.17, p=0.23) was not different. Of the cases with right aortic arch and S-shaped ascending aorta, 16 (89%) had extrinsic compression of the right pulmonary artery (p = 0.0001), while 7 (39%) had crossed pulmonaryarteries(p = 0.008), with no such findings in those with normally oriented ascending aorta or those with left aortic arch and S-shaped ascending aorta.ConclusionTetralogy of Fallot with an S-shaped ascending aorta is a variant with lesser aortic override and a more posterior location of the aorta. Compression of the right pulmonary artery and crossed pulmonary arteries are frequent when the arrangement is associated with a right-sided aortic arch. These findings may have important implications for surgical management.

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Section: Introductionmentioning

confidence: 99%

Clarifying the anatomy of tetralogy of Fallot with S-shaped ascending aorta

Gupta,

Mukharjee,

Pandey

et al. 2024

Preprint

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“…CT has unparalleled advantages, including the rapid acquisition time, exquisite spatial resolution, and accurate three-dimensional evaluation of the complex CHD anatomy 1 – 3 . Nevertheless, using ionizing radiation, a high heart rate and body motion constitute well-documented drawbacks and limitations in pediatric patients 1 , 4 .…”

Section: Introductionmentioning

confidence: 99%

Patient positioning during pediatric cardiothoracic computed tomography using a high-resilience pad system and pre-scan measurement of chest thickness

Higuchi

Nishii

Hirota

et al. 2022

Sci Rep

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Patient positioning at the isocenter of the CT gantry is important for optimizing image quality and radiation dose, but accurate positioning is challenging in pediatric patients. We evaluated whether the high-resilience pad and pre-scan measurement of chest thickness allow accurate positioning in pediatric patients with congenital heart disease. Sixty-seven patients aged 7 years or younger who underwent cardiothoracic CT were enrolled. The ideal table height, defined as the position at which the scanner’s and patient’s isocenters coincided, was determined by radiographers either manually (manual group) or based on the pad’s and chest’s thickness (calculated group). The distance between the two isocenters and image quality were evaluated. The calculated group demonstrated smaller isocenter distance and standard deviation (distance: 0.2 ± 5.8 mm vs. − 8.3 ± 11.6 mm, p < 0.01; absolute value: 4.1 [1.9–8.0] mm vs. 12.3 [5.1–16.3] mm, p < 0.01), and higher signal-to-noise ratio (SNR) and dose-normalized SNR (SNRD) in the descending aorta than the manual group (SNR: 39.8 [31.0–53.7] vs. 31.9 [28.9–36.6], p = 0.048, SNRD: 39.8 [31.0–53.7] vs. 31.9 [28.9–36.6], p = 0.04). The system allowed for more accurate positioning in pediatric cardiothoracic CT, yielding higher image quality.

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Congenital

Al‐Kindi

Janus²

2023

Cardiac MRI Certification Exam

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Cardiovascular CT in Cyanotic Congenital Heart Disease

Cited by 8 publications

References 102 publications

Clarifying the anatomy of tetralogy of Fallot with S-shaped ascending aorta

Clarifying the anatomy of tetralogy of Fallot with S-shaped ascending aorta

Patient positioning during pediatric cardiothoracic computed tomography using a high-resilience pad system and pre-scan measurement of chest thickness

Congenital

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