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

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

CT

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

Advantages

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

Disadvantage

  • 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]

Recommendation for Cardiac Computed Tomography

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

  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.

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