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Unique application of multislice computed tomography in adults with congenital heart disease
Stephen C Cook1, Subha V Raman
1Adolescent and Young Adult Congenital Heart Disease Program, The Heart Center, Columbus Children's Hospital, The Ohio State University Division of Cardiovascular Medicine, USA.
Insights
Multislice computed tomography (MSCT) effectively visualizes coronary artery anatomy in adults with congenital heart disease (CHD), identifying anomalies in 19% of patients. This noninvasive method aids in long-term management.
Area of Science:
- Cardiovascular Imaging
- Congenital Heart Disease
- Medical Diagnostics
Background:
- Adults with congenital heart disease (CHD) are a growing patient population.
- Coronary artery assessment is crucial due to increased incidence of coronary anomalies and reoperations in CHD patients.
- Defining coronary anatomy is essential for managing adults with CHD.
Purpose of the Study:
- To define the spectrum of coronary artery anatomies in adults with CHD.
- To assess the feasibility of coronary artery delineation using computed tomography angiography (CTA).
- To evaluate 16- and 64-slice CTA for coronary assessment in adults with CHD.
Main Methods:
- Review of coronary multislice computed tomography (MSCT) examinations in adults with CHD (2004-2005).
- Evaluation of image quality and coronary parameters: relationship to great arteries, ostia number/location, proximal course, vessel length, and dominance.
- Analysis of axial, multiplanar reformatted, and volume-rendered images.
Main Results:
- Eighty-five examinations in adults with CHD were analyzed.
- Relationship of great vessels, ostia characteristics, and proximal coronary course were identifiable in all studies.
- Coronary anomalies detected in 16% (19%) of subjects; entire coronary tree visible in 91%.
Conclusions:
- MSCT offers detailed, noninvasive assessment of complex coronary artery anatomy in adults with CHD.
- MSCT is a valuable tool for CHD patient assessment, requiring no arterial access.
- Provides crucial 3D anatomic information for long-term patient management.
Purpose:
Adults with congenital heart disease (CHD) form a growing population of patients requiring coronary artery assessment. In light of their increased incidence of coronary anomalies and need for reoperations, it is important to define their coronary anatomy. The purpose of this study was to define the spectrum of coronary artery anatomies and feasibility of coronary artery delineation in adults with CHD using 16- and 64-slice computed tomography angiography.
Materials And Methods:
Coronary multislice computed tomography (MSCT) examinations performed in adults with CHD between 2004 and 2005 were reviewed with institutional review board approval. Informed consent was not required. In addition to image quality, the following coronary parameters were evaluated by analysis of axial, multiplanar reformatted, and volume-rendered images: (1) relationship to great arteries, (2) ostia number and location, (3) proximal course, (4) length of vessel seen, and (5) dominance.
Results:
Eighty-five examinations in adults with CHD adults were identified. The relationship of the great vessels, number and location of the coronary ostia, and proximal course of the coronaries could be identified in all studies. Coronary anomalies were detected in 16 (19%) subjects. The entire coronary tree was visible in 77 (91%) of subjects.
Conclusions:
MSCT provides detailed, noninvasive assessment of complex coronary artery anatomy in adults with CHD. MSCT should be considered a useful modality in the assessment of these patients, as it does not require arterial access and provides detailed 3-dimensional anatomic information that has important implications for long-term management.
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