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Ahmed AN, Abozeed M, Aziz MU, Singh SP. Role of computed tomography in adult congenital heart disease: A review. J Med Imaging Radiat Sci 2021; 52:S88-S109. [PMID: 34483084 DOI: 10.1016/j.jmir.2021.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
Due to advances in cardiac surgery, perioperative care and transcatheter interventions, the majority of infants with congenital heart disease (CHD) now survive and reach adulthood. Transthoracic Echocardiography (TTE) is considered the primary imaging modality in evaluation of patients with CHD. However, in adults it can be limited due to several reasons. Although cardiac magnetic resonance (CMR) is extremely useful in evaluating cardiac morphology and function, it is not widely available, takes a long time to obtain images, and cannot be done in severely ill patients or patients that have claustrophobia. Due to high spatial and temporal resolution, isotropic imaging fast imaging and wide availability, multidetector computed tomography (MDCT) has emerged as an excellent alternative modality in the evaluation of adult congenital heart disease (ACHD). It can be performed on patients with hardware and those with claustrophobia, due to shorter image acquisition time. In this article, the commonly encountered congenital heart disorders in adults are reviewed, whether incidentally discovered on a computed tomography (CT), on a CT done to evaluate sequela of unknown CHD, or known treated CHD. To appropriately perform and evaluate CT imaging for postoperative correction or palliation congenital heart disease in adults, the imager should know the detailed cardiac anatomy, details of the operative technique used, and be familiar with the common short and long term post-operative complications.
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Affiliation(s)
- Asmaa Naguib Ahmed
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States.
| | - Mostafa Abozeed
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States
| | - Muhammad Usman Aziz
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States
| | - Satinder P Singh
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States
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2
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Parikh R, Eisses M, Latham GJ, Joffe DC, Ross FJ. Perioperative and Anesthetic Considerations in Truncus Arteriosus. Semin Cardiothorac Vasc Anesth 2018; 22:285-293. [PMID: 29808750 DOI: 10.1177/1089253218778826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Truncus arteriosus is a congenital cardiac lesion in which failure of embryonic truncal septation results in a single semilunar valve and single arterial trunk providing both pulmonary and systemic circulations. Most patients with this lesion are symptomatic in the neonatal period with cyanosis and/or congestive heart failure and undergo complete repair in the first weeks of life. This review will focus on the anatomy, physiology, and perioperative anesthetic management of patients with truncus arteriosus.
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Affiliation(s)
| | - Michael Eisses
- 2 University of Washington, Seattle, WA, USA.,3 Seattle Children's Hospital, Seattle, WA, USA
| | - Gregory J Latham
- 2 University of Washington, Seattle, WA, USA.,3 Seattle Children's Hospital, Seattle, WA, USA
| | - Denise C Joffe
- 2 University of Washington, Seattle, WA, USA.,3 Seattle Children's Hospital, Seattle, WA, USA.,4 University of Washington Medical Center, Seattle, WA, USA
| | - Faith J Ross
- 2 University of Washington, Seattle, WA, USA.,3 Seattle Children's Hospital, Seattle, WA, USA
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3
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Liu J, Li H, Liu Z, Wu Q, Xu Y. Complete Preoperative Evaluation of Pulmonary Atresia with Ventricular Septal Defect with Multi-Detector Computed Tomography. PLoS One 2016; 11:e0146380. [PMID: 26741649 PMCID: PMC4712153 DOI: 10.1371/journal.pone.0146380] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022] Open
Abstract
Objective To compare multi-detector computed tomography (MDCT) with cardiac catheterization and transthoracic echocardiography (TTE) in comprehensive evaluation of the global cardiovascular anatomy in patients with pulmonary atresia with ventricular septal defect (PA-VSD). Methods The clinical and imaging data of 116 patients with PA-VSD confirmed by surgery were reviewed. Using findings at surgery as the reference standard, data from MDCT, TTE and catheterization were reviewed for assessment of native pulmonary vasculature and intracardiac defects. Results MDCT was more accurate than catheterization and TTE in identification of native pulmonary arteries. MDCT is also the most accurate test for delineation of the major aortopulmonary collateral arteries. The inter-modality agreement for evaluation of overriding aorta and VSD were both excellent. In the subgroup with surgical correlation, excellent agreement was found between TTE and surgery, and substantial agreement was also found at MDCT. Conclusion MDCT can correctly delineate the native pulmonary vasculatures and intracardiac defects and may be a reliable method for noninvasive assessment of global cardiovascular abnormalities in patients with PA-VSD.
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Affiliation(s)
- Jingzhe Liu
- Department of Radiology, First Hospital of Tsinghua University, Beijing, China
| | - Hongyin Li
- The Heart Center, First Hospital of Tsinghua University, Beijing, China
| | - Zhibo Liu
- Department of Radiology, First Hospital of Tsinghua University, Beijing, China
| | - Qingyu Wu
- The Heart Center, First Hospital of Tsinghua University, Beijing, China
| | - Yufeng Xu
- Department of Radiology, Peking University First Hospital, Beijing, China
- * E-mail:
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4
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3D MDCT angiography for the preoperative assessment of truncus arteriosus. Clin Imaging 2015; 39:938-44. [DOI: 10.1016/j.clinimag.2015.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 07/07/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022]
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Kim YJ, Yong HS, Kim SM, Kim JA, Yang DH, Hong YJ. Korean guidelines for the appropriate use of cardiac CT. Korean J Radiol 2015; 16:251-85. [PMID: 25741189 PMCID: PMC4347263 DOI: 10.3348/kjr.2015.16.2.251] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 01/03/2015] [Indexed: 01/07/2023] Open
Abstract
The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.
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Affiliation(s)
- Young Jin Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea
| | - Sung Mok Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Jeong A Kim
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706, Korea
| | - Dong Hyun Yang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Yoo Jin Hong
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea
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6
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Computed Tomograph Cardiovascular Imaging. Coron Artery Dis 2015. [DOI: 10.1007/978-1-4471-2828-1_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Mousa TM, Akinseye OA, Kerwin TC, Akinboboye OO. A Rare Association of Sinus Venosus-Type Atrial Septal Defect and Persistent Left Superior Vena Cava Detected by Transthoracic Echocardiography and Cardiac Magnetic Resonance Imaging. Am J Case Rep 2015; 16:528-31. [PMID: 26262994 PMCID: PMC4536868 DOI: 10.12659/ajcr.894394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Tarek M. Mousa
- Department of Cardiology, Queens Heart Institute, Laurelton, NY, USA
| | - Oluwaseun A. Akinseye
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY, USA
| | - Todd C. Kerwin
- Department of Cardiology, The New York Hospital Medical Center of Queens/Cornell University Medical College, Flushing, NY, USA
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Koplay M, Cimen D, Sivri M, Güvenc O, Arslan D, Nayman A, Oran B. Truncus arteriosus: Diagnosis with dual-source computed tomography angiography and low radiation dose. World J Radiol 2014; 6:886-889. [PMID: 25431644 PMCID: PMC4241496 DOI: 10.4329/wjr.v6.i11.886] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/06/2014] [Accepted: 10/10/2014] [Indexed: 02/06/2023] Open
Abstract
Truncus arteriosus is an uncommon congenital cardiac abnormality which is characterized by a single arterial trunk origin from the heart that supplies both the systemic, pulmonary and coronary circulation. We present a preterm newborn female patient with type 2 truncusarteriosus, left superior vena cava and aberrant subclavian artery diagnosed with low dose dual-source cardiac computed tomography (CT). We discuss that low dose dual-source cardiac CT has more advantages than other imaging methods and it is an important modality for assessment of patients with conotruncal anomalies such as truncusarteriosus.
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Babaoğlu K, Altun G, Binnetoğlu K, Dönmez M, Kayabey Ö, Anık Y. Crossed pulmonary arteries: a report on 20 cases with an emphasis on the clinical features and the genetic and cardiac abnormalities. Pediatr Cardiol 2014; 34:1785-90. [PMID: 23660850 DOI: 10.1007/s00246-013-0714-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/23/2013] [Indexed: 10/26/2022]
Abstract
Crossed pulmonary arteries (CPAs) are a rare abnormality in which the ostium of the left pulmonary artery originates superior to the right pulmonary artery and to its right. Recognition of this rare pathology is important because it generally is accompanied by other congenital heart defects, extracardiac anomalies, and certain genetic problems. To date, only a few cases have been reported, and most of these cases have been associated with complex cardiac abnormalities. The authors detected 20 cases of CPA between June 2009 and November 2012 through their increasing awareness of this anomaly. Approximately 9,250 echocardiograms were performed during this period, and all of them also were checked for this anomaly. This report describes 20 cases of this CPA, with an emphasis on the clinical features and the genetic and cardiac abnormalities. The patients ranged in age from 1 day to 13 years at the time of the initial diagnosis. Four patients had complex cardiac pathologies such as tetralogy of Fallot, truncus arteriosus, transposition of the great arteries, and complete atrioventricular septal defect. Of the 20 patients, 11 had ventricular septal defects, and 12 had atrial septal defects. Pulmonary artery stenosis was detected in 12 (55 %) of the 20 patients. Aortic arch abnormalities such as interrupted aortic arch, right aortic arch, and coarctation of the aorta were detected in six patients. One patient had a left persistent superior vena cava. In 45 % of the cases, an associated genetic syndrome (DiGeorge-, Noonan-, Holt-Oram syndromes, vertebral, anal, cardiac, tracheal, esophageal, renal, limb anomalies [VACTERL] anomalies) was present. These syndromes were diagnosed based on their clinical features. Karyotype and fluorescent in situ hybridization (FISH) analyses for a 22q11 deletion were performed for 11 patients, with 10 patients found to have normal karyotype and FISH results. Only one patient had a 22q11 deletion. Six patients underwent successful operations. During the follow-up period, 3 of the 20 patients died. At this writing, the remaining patients are clinically stable and being followed without surgery. The authors believe that CPA is not a rare anomaly. If careful echocardiographic examination is performed, CPA will be diagnosed more frequently. Although this pathology usually is associated with genetic syndromes and other cardiac abnormalities, patients with CPA generally are asymptomatic.
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Affiliation(s)
- Kadir Babaoğlu
- Department of Pediatric Cardiology, School of Medicine, Kocaeli University, Kocaeli, Turkey,
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Shen Q, Pa M, Hu X, Wang J. Role of plain radiography and CT angiography in the evaluation of obstructed total anomalous pulmonary venous connection. Pediatr Radiol 2013; 43:827-35. [PMID: 23341089 DOI: 10.1007/s00247-012-2609-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 11/17/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Obstructed total anomalous pulmonary venous connection (TAPVC) is frequently misdiagnosed as pulmonary disease and without operative correction early death is common. It is important to make a correct diagnosis before surgery. OBJECTIVE The purpose of this study was to describe the chest radiographic features of obstructed TAPVC and compare CT angiography with transthoracic echocardiography in the evaluation of obstructed TAPVC. MATERIALS AND METHODS Eighteen children with obstructed TAPVC were assessed. Their clinical and imaging data were retrospectively reviewed. The characteristic radiographic findings were analyzed and compared with surgical results, and the diagnostic accuracy of CT angiography and transthoracic echocardiography was evaluated in terms of pulmonary venous drainage and obstruction detection. RESULTS The common radiographic features included pulmonary venous congestion or edema or both (16 of 18 cases, 89%), and absence of cardiomegaly (12 of 18 cases, 67%). CT angiography correctly diagnosed TAPVC and clearly revealed the draining sites in all children (five with supracardiac TAPVC, three with cardiac TAPVC, eight with infracardiac TAPVC and two with mixed TAPVC). The diagnostic agreement between CT angiography and surgery was 100%. Transthoracic echocardiography only correctly revealed the draining sites in 11 children (5 with supracardiac TAPVC, 2 with cardiac TAPVC and 4 with infracardiac TAPVC). The diagnostic agreement between transthoracic echocardiography and surgery was 61%. The diagnostic accuracy of CT angiography was higher than that of transthoracic echocardiography (P = 0.0156). Thirty-four sites of obstruction were correctly detected by CT angiography (11 in the mediastinum, 1 at the diaphragmatic level, 9 below the diaphragm and 13 stenotic individual pulmonary veins in the lung). The diagnostic agreement between CT angiography and surgery was 92%. Transthoracic echocardiography only correctly detected 15 sites of obstruction (11 in the mediastinum, 1 at the diaphragmatic level and 3 below the diaphragm). The diagnostic agreement between transthoracic echocardiography and surgery was 41%. The rate of detection for sites of obstruction with transthoracic echocardiography was much lower than that of CT angiography (P = 0.0002). CONCLUSION In children with obstructed TAPVC, plain radiographs usually show a characteristic pattern of pulmonary venous congestion or edema, or both, and a normal cardiac silhouette. CT angiography is superior to transthoracic echocardiography in the evaluation of pulmonary venous drainage and obstruction, especially in children with infracardiac and mixed TAPVC.
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Affiliation(s)
- Quanli Shen
- Department of Radiology, Children's Hospital, Fudan University, 399 Wanyuan St., Shanghai, China, 201102
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Watts JR, Sonavane SK, Singh SP, Nath PH. Pictorial Review of Multidetector CT Imaging of the Preoperative Evaluation of Congenital Heart Disease. Curr Probl Diagn Radiol 2013; 42:40-56. [DOI: 10.1067/j.cpradiol.2012.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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12
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Non-ECG-gated MDCTA of infracardiac total anomalous pulmonary venous connection in neonates and young infants. Herz 2013; 38:539-43. [DOI: 10.1007/s00059-012-3728-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/25/2012] [Accepted: 10/28/2012] [Indexed: 11/30/2022]
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13
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Amat F, Le Bret E, Sigal-Cinqualbre A, Coblence M, Lambert V, Rohnean A, Paul JF. Diagnostic accuracy of multidetector spiral computed tomography for preoperative assessment of sinus venosus atrial septal defects in children. Interact Cardiovasc Thorac Surg 2011; 12:179-82. [DOI: 10.1510/icvts.2010.251298] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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14
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Echocardiographic and three-dimensional computed tomographic diagnosis of crossed pulmonary arteries: report of three cases. Pediatr Cardiol 2010; 31:720-2. [PMID: 20217064 DOI: 10.1007/s00246-010-9664-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 01/20/2010] [Indexed: 10/19/2022]
Abstract
Crossed pulmonary arteries are rare anomalies of the pulmonary trunk and its branches. In this anomaly, the ostium of the left pulmonary artery originates superiorly and to the right of the right pulmonary artery. This anomaly is usually associated with other congenital cardiac and extracardiac diseases. We report three neonates with congenital cardiac diseases who had this anomaly, which was detected first by echocardiography and then confirmed by cardiac three-dimensional computed tomography.
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15
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Congenital Heart Disease and Multi-modality Imaging. Heart Lung Circ 2010; 19:133-44. [DOI: 10.1016/j.hlc.2010.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 12/09/2009] [Accepted: 01/04/2010] [Indexed: 11/20/2022]
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Brown DW, Powell AJ, Geva T. Imaging complex congenital heart disease — functional single ventricle, the Glenn circulation and the Fontan circulation: A multimodality approach. PROGRESS IN PEDIATRIC CARDIOLOGY 2010. [DOI: 10.1016/j.ppedcard.2009.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Bhalla S, Javidan-Nejad C, Bierhals AJ, Woodard PK, Gutierrez FR. CT in the evaluation of congenital heart disease in children, adolescents, and young adults. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2008; 10:425-32. [DOI: 10.1007/s11936-008-0034-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
A large number of patients in developing countries require surgical correction of congenitally malformed hearts. Unfortunately, only a limited number of centres offer these patients surgery at an affordable cost. In this review, we discuss the problems in managing these patients, with an emphasis on reduction of costs, so that the maximum number of patients can benefit. It is apparent that containing costs requires a multipronged approach, which begins with timely referral, and continues with early surgical correction and adequate postoperative care carried out in a scientific manner. Indigenization, innovation, training of manpower, and building a team, are essential to cut the costs, and to improve the quality of care.
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Chen BB, Hsieh HJ, Chiu IS, Chen SJ, Wu MH. Crossed Pulmonary Arteries: Report of Two Cases with Emphasis on Three-dimensional Helical Computed Tomographic Imaging. J Formos Med Assoc 2008; 107:265-9. [DOI: 10.1016/s0929-6646(08)60146-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Arain NI, Batten LA, Cole JH. Computed tomography angiography of a coronary artery fistula. Pediatr Cardiol 2008; 29:234-5. [PMID: 17882477 DOI: 10.1007/s00246-007-9089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 06/27/2007] [Accepted: 06/28/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Nofil I Arain
- Department of Pediatrics, University of South Alabama, Mobile, AL 36604, USA
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Wang XM, Wu LB, Sun C, Liu C, Chao BT, Han B, Zhang YT, Chen HS, Li ZJ. Clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot. Eur J Radiol 2007; 64:296-301. [PMID: 17399932 DOI: 10.1016/j.ejrad.2007.02.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Revised: 02/16/2007] [Accepted: 02/23/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore the clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot. METHODS Eighteen patients with diagnosed Tetralogy of Fallot underwent cardiac CT angiography with 64-slice CT (CTA). Two- and three-dimensional images were used for diagnosing in all cases by means of MPR (coronal, sagital and oblique), cMPR, MIP and VRT. RESULTS All patients had ventricular septal defect, pulmonary stenosis and hypertrophy of right ventricle. The morphologic features of Tetralogy of Fallot were equal to echocardiography. Patent ductus arteriosus (PDA) were detected on eight patients. Main coronary artery branches and partial sub-branches were visualized in all patients. Abnormal coronary arteries were found in seven cases: both left and right main coronary artery arising from the right aortic sinus one case, right main coronary artery and circumflex (CX) arising from the right aortic sinus one case, left anterior descending (LAD) and CX arising from left aortic sinus directly one case, left and right coronary artery arising from back and front of the aortic sinus, respectively, three cases. Pulmonary artery branch stenosis was found in 12 cases and branch pulmonary artery dilation noticed in 1 case. Double superior vena cava was also found in one case. According to the surgery the diagnostic accuracy of CT and Echocardiography was 95.45 and 83.33%, respectively. CONCLUSION Two- and three-dimensional 64-slice CTA not only show the overall anatomical structure of the heart, but also show coronary and pulmonary arteries. With these results, evaluation of coronary anomalies and pulmonary artery stenosis with 64-MSCT is extremely valuable for planning the operative procedure on the patients with Tetralogy of Fallot.
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Affiliation(s)
- Xi-Ming Wang
- Tianjin Medical University, Tianjin City, PR China.
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22
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Abstract
The most common imaging modality used for diagnosis of aortic disease is CT, followed by transesophageal echocardiography, MRI, and aortography. If multiple imaging is performed, the initial imaging technique most frequently employed is computerized tomography. During the past decade, computed tomographic angiography (CTA) has become a standard non-invasive imaging modality for the depiction of vascular anatomy and pathology. The quality and speed of CTA examinations have increased dramatically as CT technology has evolved from-channel spiral CT systems to multichannel (4-, 8-, 10- and 16-slice) spiral CT system. The quality and speed of CTA is superior to other imaging modalities, and it is also cheaper and less invasive. CTA of the aorta has proven to be superior in diagnostic accuracy to conventional arteriography in several applications.
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Affiliation(s)
- Tongfu Yu
- Radiological Department of the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
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23
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Computed Tomographic Cardiovascular Imaging. CARDIOVASCULAR MEDICINE 2007. [DOI: 10.1007/978-1-84628-715-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Boxt LM. Magnetic resonance and computed tomographic evaluation of congenital heart disease. J Magn Reson Imaging 2004; 19:827-47. [PMID: 15170787 DOI: 10.1002/jmri.20077] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Magnetic resonance imaging (MRI) and contrast-enhanced computed tomography (CT) provide noninvasive visualization of morphologic changes in pediatric and adult patients with congenital heart disease, as well as the functional changes caused by the underlying morphologic abnormalities. Clinical experience with MRI is richer than that with fast CT, but CT appears to provide accurate and high-quality imagery for diagnosis. The two modalities may be complementary. That is, intracardiac anatomy is so well depicted by MRI, and CT provides exquisite images of the great vessels. Furthermore, in adult patients, MR and CT are helpful in demonstrating and quantitating physiologic changes superimposed by acquired cardiovascular disease on the underlying congenital malformations. Using MRI, spin echo acquisitions provide the image data for evaluation of morphologic changes, and gradient reversal techniques add functional and flow data to complement morphologic changes. Contrast-enhanced electrocardiographic (ECG)-gated multidetector and electron beam CT examination provide morphologic information and may be used as a data set for off-line functional quantitation.
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Affiliation(s)
- Lawrence M Boxt
- Division of Cardiovascular Imaging, Department of Radiology, Beth Israel Medical Center, New York, New York 10003, USA.
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25
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Affiliation(s)
- Frandics P Chan
- Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, S-066, Stanford, CA 94305-5105, USA
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26
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Balci NC, Yalçin Y, Tunaci A, Balci Y. Assessment of the anomalous pulmonary circulation by dynamic contrast-enhanced MR angiography in under four seconds. Magn Reson Imaging 2003; 21:1-7. [PMID: 12620540 DOI: 10.1016/s0730-725x(02)00634-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to demonstrate the initial results of the dynamic contrast-enhanced MRA in under four seconds in the assessment of anomalous pulmonary circulation. We performed dynamic contrast enhanced MRA on ten patients with a temporal resolution of 2-3 sec for each phase. Five patients had pulmonary vascular anomaly and five patients had reconstructed pulmonary circulation. On nine patients catheter angiography was performed for the correlation. Dynamic contrast-enhanced MRA successfully demonstrated congenital pulmonary vascular anomalies and the pathway of anomalous pulmonary circulation in our series. With the improved temporal and spatial resolution, the dynamic contrast-enhanced MRA can be used in children and infants for the assessment of congenital vascular disease.
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Affiliation(s)
- N Cem Balci
- Department of Radiology, Florence Nightingale Hospital, Istanbul, Turkey.
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Shiraishi I, Yamamoto Y, Ozawa S, Kawakita A, Toiyama K, Tanaka T, Sakata K, Hayano T, Itoi T, Yamagishi M, Hamaoka K. Application of helical computed tomographic angiography with differential color imaging three-dimensional reconstruction in the diagnosis of complicated congenital heart diseases. J Thorac Cardiovasc Surg 2003; 125:36-9. [PMID: 12538981 DOI: 10.1067/mtc.2003.124] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Isao Shiraishi
- Division of Pediatrics, Division of Pediatric Cardiovascular Surgery, Children Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Ravenel JG, McAdams HP, Remy-Jardin M, Remy J. Multidimensional imaging of the thorax: practical applications. J Thorac Imaging 2001; 16:269-81. [PMID: 11685092 DOI: 10.1097/00005382-200110000-00008] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Over the past decade, faster CT scan times, thinner collimation, and the development of multirow detectors, coupled with the increasing capability of computers to process large amounts of data in short periods of time, have lead to an expansion in the ability to create diagnostically useful two-dimensional (2D) and three-dimensional (3D) images within the thorax. Applications within the thorax include, but are not limited to, evaluation of pulmonary and systemic vasculature, evaluation of the tracheobronchial tree, and delineation of diffuse lung disease. Pulmonary nodule volume and growth can be more accurately predicted, and represents an improvement in the evaluation of the solitary pulmonary nodule. Multiplanar images increase our understanding of thoracic anatomy and can help to guide bronchoscopic procedures. Because there are strengths and weaknesses to all the reconstruction algorithms, the utility of any given technique is dependent on the clinical question to be answered. For instance, although maximum intensity projection imaging (MIP) is helpful in the evaluation of micronodular lung disease, it is of little value in the diagnosis of aortic dissection. As the ability to generate faster and more precise multidimensional images grow, the demand for such imaging is likely to increase. In this review, the authors discuss the various reconstruction techniques available, followed by a discussion of the clinical applications.
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Affiliation(s)
- J G Ravenel
- Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Abstract
Radiology in the evaluation of congenital heart disease has changed over the years but still has an important role to play. Although we can rarely make the definitive diagnosis of the intracardiac abnormalities, we can direct the clinicians' attention when cardiac disease is unsuspected and we can assist in the evaluation of complications of the disease or its treatment.
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Affiliation(s)
- B J Wolfson
- Department of Radiologic Sciences, MCP-Hahnemann School of Medicine, Philadelphia, Pennsylvania, USA
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Abstract
Imaging algorithms in congenital heart disease, as in the patient with acquired heart diseases continue to evolve, with more and more information gleaned noninvasively. The emphasis will be on the newer aspects of imaging, not cross sectional echocardiography with color Doppler.
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Affiliation(s)
- J Russell
- Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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