Congenital heart disease CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Keri Shafer, M.D. [2],Atif Mohammad, M.D., Priyamvada Singh, MBBS

## Overview

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Computed tomography can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.

## CT

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Computed tomography (CT) can be used as a diagnostic modality in congenital heart diseases.

#### Advantages

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* Provides additional anatomic details compared to echocardiography
* It is done faster compared to MRI, thus avoiding the need for anesthesia in small children.

#### Disadvantage

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* Costly
* Radiation can have long terms side-effect on growing children.

## 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[1]

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### Recommendation for Cardiac Computed Tomography

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The accompanying ionizing radiation exposure is the primary drawback of cardiac computed tomography as an imaging technology (including CT angiography). This is especially problematic for ACHD patients for whom lifetime serial examinations are planned. At the expense of a greater radiation dose, gating CCT to the ECG enables image acquisition during several phases of the cardiac cycle, enabling cine imaging and the choice of specific cycle periods of interest (often end-systole and end-diastole).

Class IIa

1.CCT imaging can be useful in patients with ACHD when information that cannot be obtained by other diagnostic modalities is important enough to justify the exposure to ionizing radiation. (Level of Evidence: C-LD)

## References

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1. ↑ Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM; et al. (2019). "2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J Am Coll Cardiol. 73 (12): 1494–1563. doi:10.1016/j.jacc.2018.08.1028. PMID 30121240.CS1 maint: Multiple names: authors list (link)

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Congenital malformations and deformations of circulatory system (Q20-Q28, 745-747)

Cardiac chambers and connections|

Persistent truncus arteriosus \- Double outlet right ventricle (Taussig-Bing syndrome) - Transposition of the great vessels (dextro, levo)

Cardiac septa|

Ventricular septal defect \- Atrial septal defect (Lutembacher's syndrome) - Atrioventricular septal defect (Ostium primum) - Tetralogy of Fallot \- Eisenmenger's syndrome

Right: pulmonary and tricuspid valves|

pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, atresia) - Ebstein's anomaly

Left: aortic and mitral valves|

aortic valves (stenosis, insufficiency, bicuspid) - mitral valves (stenosis, regurgitation) - Hypoplastic left heart syndrome

Other congenital malformations
of heart|

Dextrocardia \- Levocardia \- Cor triatriatum

Great arteries|

aorta (Patent ductus arteriosus, Aortic coarctation, Interrupted aortic arch, Overriding aorta, Aneurysm of sinus of Valsalva, Vascular ring) - Pulmonary atresia

Great veins|

Persistent left superior vena cava \- Total anomalous pulmonary venous connection \- Scimitar syndrome

Other|

Arteriovenous malformation (Cerebral arteriovenous malformation)

See also non-congenital conditions (I, 390-459)

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