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Congenitally corrected transposition in the adult: detection by radionuclide angiocardiography
Insights
Congenitally corrected transposition (CCT) is a rare heart defect. Radionuclide angiocardiography provides reliable diagnostic criteria for CCT in adults, independent of situs or cardiac position.
Area of Science:
- Cardiology
- Medical Imaging
- Pediatric Cardiology
Background:
- Congenitally corrected transposition (CCT) of the great vessels is an uncommon cardiac anomaly.
- Often detected in childhood due to severe associated malformations, CCT can present in adulthood if these are absent, though cardiac abnormalities are typically present.
- Diagnosing CCT in adults using ultrasound can be challenging.
Abstract:
Congenitally corrected transposition (CCT) of the great vessels is an uncommon anomaly usually detected in children because of associated severe cardiac malformations. When these are absent, patients may be hemodynamically normal, but associated cardiac abnormalities are usually present in CCT, leading to symptoms in adulthood. When CCT is suggested in an adult, diagnosis by means of ultrasound may be difficult. Radionuclide angiocardiography (RA) is a simple, noninvasive method by which to diagnose CCT. We found consistent morphologic scintigraphic results in 13 patients with proved CCT, leading to establishment of reliable diagnostic criteria. In all instances of situs solitus the aorta ascends and descends on the left with vertical orientation. In the case of situs inversus, the aorta ascends and descends on the right with vertical orientation. Our criteria are independent of the situs and cardiac position, unlike earlier reports by others. We believe images obtained in the anterior projection are sufficient for the study. The practical application of RA study in patient diagnosis is demonstrated, giving special attention to patients referred because of situs solitus and dextrocardia, in which CCT is known to be present in 50% of cases.