Congenital heart diseases: post-operative appearance on multi-detector CT—a pictorial essay

Tomasian, Anderanik; Malik, Sachin B.; Shamsa, Kamran; Krishnam, Mayil S.

doi:10.1007/s00330-009-1474-7

Cited by 22 publications

(12 citation statements)

References 15 publications

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“…Bicaval Glenn shunt is an anastomosis of both SVCs to pulmonary arteries in the presence of PLSVC. The Glenn shunt allows the direct drainage of venous blood into the pulmonary arteries via bypassing the right heart chambers [40,41].…”

Section: Vascular Structures Secondary To Surgerymentioning

confidence: 99%

Persistent left superior vena cava: clinical importance and differential diagnoses

et al. 2020

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Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly and may be a component of the complex cardiac pathologies. While it is often asymptomatic, it can lead to significant problems such as arrhythmias and cyanosis. Besides, it can cause serious complications during vascular interventional procedures or the surgical treatment of cardiac anomalies (CA). The clinical significance of PLSVC depends on the drainage site and the accompanying CA. In this article, we will describe the epidemiology, embryology, and anatomic variations of PLSVC. Possible accompanying CA and heterotaxy spectrum will be reviewed with the help of multidetector computed tomography (MDCT) images. Radiological pitfalls, differential diagnoses, and the clinical importance of PLSVC will be highlighted.

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Section: Vascular Structures Secondary To Surgerymentioning

confidence: 99%

Persistent left superior vena cava: clinical importance and differential diagnoses

et al. 2020

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“…A fenestration may be created between the Fontan pathway and the atrium, allowing systemic venous blood to bypass the lungs and enter the atrium. Although this fenestration allows a right-to-left shunt and resultant systemic desaturation, it improves the postoperative course by reducing systemic venous pressure and augmenting cardiac output (19,20).…”

Section: Stage 3: Tcpcmentioning

confidence: 99%

CT for Assessment of Thrombosis and Pulmonary Embolism in Multiple Stages of Single-Ventricle Palliation: Challenges and Suggested Protocols

Mahani

Agarwal²,

Rigsby

et al. 2016

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The total cavopulmonary connection (TCPC), or Fontan procedure, diverts systemic venous blood directly into the pulmonary arteries and is the palliative surgery of choice for patients with a wide variety of congenital heart diseases with single-ventricle physiologic characteristics. Pulmonary embolism and thrombosis are known complications and are among the major causes of morbidity and mortality in patients after TCPC. Magnetic resonance (MR) imaging is usually performed for postoperative evaluation of patients after single-ventricle repair; however, screening for thrombosis or embolism with MR imaging is not always feasible because of the emergent nature of the clinical presentation or because of artifacts from metallic devices or coils. Computed tomographic (CT) angiography is an effective method for diagnosing pulmonary embolism in children. However, because of altered hemodynamics after single-ventricle palliation, there are unique challenges in achieving optimal opacification of the pulmonary arteries and Fontan circuit that can result in nondiagnostic CT angiographic studies or erroneous image interpretation. Radiologists should be familiar with the multiple stages of single-ventricle palliation, understand the technique for performing pulmonary CT angiography at each stage, and recognize common pitfalls in obtaining and interpreting pulmonary CT angiographic images in patients who have undergone single-ventricle repair. Online supplemental material is available for this article. (©)RSNA, 2016.

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“…13a). Hence, injecting contrast only through the arm will not result in opacification of the left pulmonary arteries and injection through the lower extremity will not result in opacification of right pulmonary arteries, resulting in non-diagnostic studies [26]. This is important since there is a higher risk of pulmonary thromboembolism (3–19 %) in these patients [27].…”

Section: Technical Causes Of Poor Contrast Opacification Of Target Vementioning

confidence: 99%

“…(2) Two-phase CT angiography, with both arterial and delayed venous phases (Fig. 12b, Movie 2) [26]. Delayed phase scan only.…”

Section: Technical Causes Of Poor Contrast Opacification Of Target Vementioning

confidence: 99%

Contrast opacification on thoracic CT angiography: challenges and solutions

et al. 2016

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Contrast flow and enhancement patterns seen on thoracic CT angiography (CTA) can often be challenging and may often reveal more than is immediately apparent. A non-diagnostic CTA following the initial contrast injection can be secondary to many causes; these include both extrinsic factors, such as injection technique/equipment failure (iv cannula, power injector), and intrinsic, patient-related factors. Contrast pressure and flow graphs often contain useful information regarding the etiology of a non-diagnostic scan. Understanding these graphs will help the radiologist plan a repeat contrast injection to overcome the deficiencies of the first injection and thus obtain a diagnostic scan. The current review article outlines normal and abnormal intravenous contrast dynamics, discusses how to recognize etiologies of non-diagnostic scans, and ultimately addresses techniques to overcome obstacles towards obtaining normal contrast opacification of the target vessel. In addition, there are some life-threatening findings, which unless sought for, may remain hidden in plain sight. Key Points • Using contrast enhancement and flow patterns to identify the cause of a non-diagnostic CTA.• Recognize life threatening causes of altered contrast dynamics such as cardiac asystole.• Non-target vessel opacification may hold key to underlying pathophysiology.Electronic supplementary materialThe online version of this article (doi:10.1007/s13244-016-0524-3) contains supplementary material, which is available to authorized users.

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Congenital heart diseases: post-operative appearance on multi-detector CT—a pictorial essay

Cited by 22 publications

References 15 publications

Persistent left superior vena cava: clinical importance and differential diagnoses

Persistent left superior vena cava: clinical importance and differential diagnoses

CT for Assessment of Thrombosis and Pulmonary Embolism in Multiple Stages of Single-Ventricle Palliation: Challenges and Suggested Protocols

Contrast opacification on thoracic CT angiography: challenges and solutions

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