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Optimizing Computed Tomography for Detection of Pulmonary Thromboembolism in Patients With Fontan Circulation

Sohab Radwan1, Gauravpal S Gill1, Amre Ghazzal1

  • 1Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA.

Cureus
|June 6, 2020
PubMed

Insights

Diagnosing pulmonary thromboembolism in Fontan procedure patients using CT scans is challenging due to altered anatomy. Pre-procedure review guides CT technique, reducing errors, radiation, and costs.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Patients with congenital heart disease (CHD) often undergo the Fontan procedure, resulting in unique vascular alterations.
  • These anatomical changes complicate the diagnosis of pulmonary thromboembolism (PTE) using computed tomography (CT).

Observation:

  • Altered vascular anatomy in Fontan patients complicates standard CT interpretation for PTE.
  • Inaccurate diagnoses can lead to unnecessary anticoagulation or missed diagnoses.

Findings:

  • A detailed review of surgical history and individual anatomy is crucial before CT.
  • This review helps select the optimal CT modality and technique for accurate PTE diagnosis.

Implications:

  • Tailored CT protocols can minimize false-positive and false-negative results in Fontan patients.
  • Optimized imaging reduces patient exposure to radiation and lowers healthcare costs.

Keywords:
computed tomographyfontanpulmonary embolism

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