Computed Tomography Pulmonary Angiography in Evaluation of Congenital Heart Diseases

Abstract

Congenital heart disease (CHD) still accounts for significant morbidity and mortality, despite major advances in diagnosis and management. A significant proportion of CHD is still undiagnosed at birth emphasizing the need for a detailed history and meticulous clinical examination. CHD is common and early detection and comprehensive functional and physiological evaluation is very important. Usually echocardiography is the initial diagnostic modality for patients with suspected CHD; in some patients this modality can be limited in its ability to delineate great artery and intracardiac anomalies, pulmonary veins, and coronary arteries. Magnetic resonance imaging is an excellent tool due to its non-ionizing nature and exquisite anatomic and functional capabilities. Computed tomography (CT) pulmonary angiography can be used to assess complex cardiovascular anatomic features both before and after surgery and of a variety of post-treatment complications. In CHD it is very important to have extensive knowledge of cardiovascular anatomy, physiology, and surgical techniques. Recent developments in CT technology primarily by reducing the cardiac motion and the radiation dose usage in CHD evaluation have helped expand the indications for CT usage. It has become a very useful complementary tool to guide the proper medical and surgical management. The purpose of the article is to review the role of CT pulmonary angiography in the evaluation of congenital cardiovascular disease with emphasis on its type, nature and anatomic details.