Diagnostic accuracy of dual-source multislice computed tomographic analysis for the preoperative detection of coronary artery anomalies in 100 patients with tetralogy of Fallot

Abstract

Dual-source computed tomographic analysis is an accurate and noninvasive tool for delineating coronary artery anatomy before surgical intervention in children with tetralogy of Fallot. Dual-source computed tomographic analysis might deserve to be used routinely instead of angiographic analysis and in combination with echocardiographic analysis for the preoperative assessment of patients with tetralogy of Fallot.

Evaluation of High-Pitch Ungated Pediatric Cardiovascular Computed Tomography for the Assessment of Cardiac Structures in Neonates

“…However, a small, but significant, proportion (7% to 9%) of children with congenital heart disease also have associated coronary artery anomalies, 24,25 often resulting in the need for preoperative coronary artery assessment and pulmonary venous return assessment. In this pediatric population, the majority of coronary artery analyses focus on the presence or absence of arteries and their proximal course rather than excluding stenotic lesions.…”

Multimodality Imaging Guidelines of Patients with Transposition of the Great Arteries: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography

“…Proximal CA evaluation in infants using free breathing techniques and without bblockade shows excellent correlation to surgical findings. 147 When sedation or anesthesia is needed, no change in equipment is required and the anesthesia period is relatively short, because the data can be acquired in a few breath hold sequences. Up to 15% of patients have pacemakers after the AtrSO because of atrial arrhythmias, sinus node dysfunction, or heart block.…”

“…Estimated radiation doses of approximately 1 mSv are reported for a wide range of congenital cardiac applications, including a cohort of pediatric patients with electrocardiographically triggered coronary scans. 145,147,[175][176][177][178] Not all centers have achieved this ability as of yet.…”

Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT)

“…[189][190][191][192][193][194][195][196] Multimodality imaging is often needed for complete assessment and serial evaluation in these patients. MRI is considered by many experts to be the modality of choice for investigation after TOF repair unless detailed coronary imaging is needed.…”

“…217 A preoperative study in 100 patients under one year of age with TOF demonstrated that cardiovascular CT provided 100% sensitivity and specificity for coronary artery anatomy compared to surgical findings, with a radiation dose less than 1 mSv. 189 Coronary artery anatomy must be clearly defied prior to repeat intervention on the RVOT. 23 This is essential in patients undergoing repeat sternotomy with a substernal coronary artery, and also for those being considered for transcatheter pulmonary valve placement due to potential for coronary artery compression with device placement.…”