Computed tomographic versus catheterization angiography in tetralogy of Fallot

Garg, Naveen; Walia, Rohit; Neyaz, Zafar; Kumar, Sunil

doi:10.1177/0218492314538844

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…10 Garg et al, studied the MDCT vs. CCA in CHD diagnosis and found few small VSDs were missed on MDCT. 9 These findings correlate with our study. In this study, we found 9 patients (18%) of ASD without other anomalies like pulmonary stenosis, MPA, TOF, and other pathologies.…”

Section: Discussionsupporting

confidence: 92%

“…8 Garg et al, studied the MDCT vs. CCA in diagnosing TOF and found 100% sensitivity, specificity and accuracy. 9 Complete concordance between the diagnosis of RVOT, pulmonary artery anatomy, pulmonary annulus size, side of aortic arch and detection of collaterals was found. In this study, we found 36 (72%) patients of VSD without other anomalies like pulmonary stenosis, MPA, TOF, and other pathologies.…”

Section: Discussionmentioning

confidence: 64%

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Role of multi-detector computed tomography in congenital heart diseases

Mangal¹,

Jain²,

Amin³

et al. 2018

Int J Res Med Sci

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Background: The study aimed to assess sensitivity, specificity and accuracy of CT scan in diagnosing various cardiovascular anomalies in patients with complex congenital heart disease; to obtain additional information in pre-operative patients, inconclusive on echocardiography; and to compare results of multi-detector computed tomography (MDCT) with cardiac catheter angiography (CCA) in accurately delineating the cardiovascular morphological features and to determine if MDCT can replace diagnostic CCA in evaluation of complex CHD.Methods: In this prospective, comparative, single-centre study, a total 50 patients were included in the study aged between 6 days to 17 years. All patients were referred by pediatric cardiologists between August, 2014 and November, 2016. All patients had undergone initial echocardiography and final diagnosis was confirmed by comparing MDCT data with CCA.Results: Total of 177 cardiovascular anomalies are found in our study of 50 patients out of these 3 cases of VSD and one case of ASD was missed on CT angiography and its overall accuracy as compared to catheter angiography was found to be 97.1% Its accuracy in evaluation of TOF, DORV, TAPVC, TA TGA, COA, right sided aortic arch, MAPVC, persistent SVC, PDA, PS, vascular sling and coronary cameral fistula was 100%.Conclusions: The MDCT is found comparable to CCA in the diagnosis of extra cardiac vascular anomalies but the overall sensitivity in the diagnosis of intra-cardiac anomalies is little lower. It can be used as a substitute to CCA in complex CHD and is very helpful tool in preoperative planning and postoperative follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 64%

Role of multi-detector computed tomography in congenital heart diseases

Mangal¹,

Jain²,

Amin³

et al. 2018

Int J Res Med Sci

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“…These findings are similar to reported clinical series [15, 16]. Anomalous coronary arteries are at risk of transection during complete repair, especially if mistaken for a large infundibular or conal branch [17]. There is no consensus on how to deal with such anomalous coronary arteries.…”

Section: Discussionsupporting

confidence: 85%

Tetralogy of Fallot: morphological variations and implications for surgical repair

Khan

Drury

Stickley

et al. 2019

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Tetralogy of Fallot is characterized by anterocephalad deviation of the outlet septum, along with abnormal septoparietal trabeculations, which lead to subpulmonary infundibular stenosis. Archives of retained hearts are an important resource for improving our understanding of congenital heart defects and their morphological variability. This study aims to define variations in aortic override, coronary arterial patterns and ventricular septal defects in tetralogy of Fallot as observed in a morphological archive, highlighting implications for surgical management. METHODS The Birmingham Children’s Hospital archive contains 211 hearts with tetralogy of Fallot, of which 164 were analysed [69 (42.1%) unrepaired and 95 (57.9%) operated specimens]. A detailed morphological and geometric analysis was performed using a rigorous 5-layer review process. RESULTS Anomalies were observed in the orifices, origins and course of the coronary arteries: 20 hearts (13.0%) had more than 2 orifices and 3 hearts (1.9%) had a single orifice. In 7 hearts (4.3%), a coronary artery crossed the right ventricular outflow tract. The extent of aortic override ranged from 31.0% to 100% (median of 59.5%). The ventricular septal defect was most often perimembranous (139, 84.8%), but we also found muscular (14, 8.5%), atrioventricular (7, 4.3%) and doubly committed juxta-arterial (2, 1.2%) variants. CONCLUSIONS Anatomical variations are common and can impact surgical management. Anomalous coronary arteries may require a conduit rather than a transannular patch. Variability in aortic override determines the size of patch used to baffle blood to the aorta. The type of ventricular septal defect affects patch closure and the risk of postoperative conduction defects.

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“…Thus, DSCT was performed strictly in accordance with the ALARA (as low as reasonably achievable) principle in the present study. It is worth noting that several measures were applied to minimize the estimated mean ED to < 1 mSv (0.86 ± 0.47 mSv), which is much lower than that of CCA (approximately 4.6 mSv) [ 21 , 22 ], including decreasing the tube voltage to the low level of 80 kV, applying the heart rhythm adaptive pitch, and using ECG-based tube current modulation as shown in previous studies [ 23 – 25 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of tetralogy of Fallot–associated congenital extracardiac vascular anomalies in pediatric patients using low-dose dual-source computed tomography

Shi

Deng³

et al. 2017

BMC Cardiovasc Disord

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BackgroundTo investigate the diagnostic value of dual-source computed tomography (DSCT) in the evaluation of tetralogy of Fallot (TOF)-associated extracardiac vascular abnormalities in pediatric patients compared with transthoracic echocardiography (TTE).MethodsOne hundred and twenty-three pediatric patients diagnosed with TOF were included in this retrospective study. All patients underwent DSCT and TTE preoperatively. All associated extracardiac vascular abnormalities and their percentages were recorded. The diagnostic performances of DSCT and TTE were compared based on the surgical results. The image quality of DSCT was rated, and the effective radiation dose (ED) was calculated.ResultsA total of 159 associated extracardiac vascular deformities were confirmed by surgery. Patent ductus arteriosus (36, 22.64%), right-sided aortic arch (29, 18.24%), and pulmonary valve stenosis (23, 14.47%) were the most common associated extracardiac vascular abnormalities. DSCT was superior to TTE in demonstrating associated extracardiac anomalies (diagnostic accuracy: 99.13% vs. 97.39%; sensitivity: 92.45% vs. 77.07%; specificity: 99.81% vs. 99.42%). The agreement on grading the image quality of DSCT was excellent (κ = 0.80), and the mean score of the image quality was 3.39 ± 0.50. The mean ED of DSCT was 0.86 ± 0.47 mSv.ConclusionsCompared to TTE, low-dose DSCT has high diagnostic accuracy in the depiction of associated extracardiac vascular anomalies in pediatric patients with TOF, and could provide more morphological details for surgeons.

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Computed tomographic versus catheterization angiography in tetralogy of Fallot

Abstract: For preoperative evaluation of tetralogy of Fallot patients, multidetector computed tomographic angiography can be used as a reliable noninvasive alternative to cardiac catheterization angiography.

Cited by 8 publications

References 15 publications

Role of multi-detector computed tomography in congenital heart diseases

Role of multi-detector computed tomography in congenital heart diseases

Tetralogy of Fallot: morphological variations and implications for surgical repair

Assessment of tetralogy of Fallot–associated congenital extracardiac vascular anomalies in pediatric patients using low-dose dual-source computed tomography

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