The DIAGNOSTIC CARDIAC CATHETRIZATION IN CHILDREN WITH TETRALOGY OF FALLOT: STILL RELEVANT IN DEVELOPING WORLD

Abstract

Objective: To determine the frequency of various anatomical cardiac anomalies and variations in children with Tetralogy of Fallot diagnosed by cardiac catheterization.
 Study Design: Cross sectional study.
 Place and Duration of Study: Children's Hospital and Institute of Child Health Lahore, from Jan 2010 to Dec 2018.
 Methodology: All children with tetralogy of fallot underwent standard cine-angiograms after obtaining written consent following basic laboratory workup.
 Results: Out of 425 patients, 398 completed cardiac catheterization. The median age was 6 years (interquartile range 3.5-9 years). Confluent Branch pulmonary arteries were present in 395 (99%) children. Pulmonary artery abnormalities were detected in 72 (18%) patients. Two hundred and eleven (53%) children had 283 major aortopulmonary collateral arteries with 88 having 2 or more major aortopulmonary collateral arteries. Out of all, 195 (92%) had hemodynamically significant Major aortopulmonary collateral arteries (supplying ≥3 lung segments) with 54 (28%) having small (<1.33mm at origin), 105 (54%) moderate (1.33-1.67 mm at origin) and 36 (18%) large (>1.67 mm at origin) caliber.
 Conclusion: The frequencies of pulmonary artery abnormalities and various anatomic variations missed on echocardiography in the studied population were high. Diagnostic cardiac catheterization is still a relevant invasive diagnostic procedure in children with tetralogy of fallot.
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