Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Background Tetralogy of Fallot is the most common congenital cyanotic heart disease. Advances in surgical repair recently facilitate survival of the affected patients into adulthood with good quality of life. Despite imaging plays crucial role in diagnosis of TOF patients, no single diagnostic modal...

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Bibliographic Details
Published in:Egyptian journal of radiology and nuclear medicine 2021-02, Vol.52 (1), p.47-14
Main Authors: Moustafa, Sherif Abd El Fattah, Hussein, Manar Mansour, Sultan, Amina Ahmed, Bilal, Maha Mohamed Zaki, El Gamal, Mohamed Adel Fetoh, Sobh, Donia Mohamed
Format: Article
Language:English
Subjects:
Anesthesia
Cardiovascular disease
Catheters
Congenital cyanotic heart disease
Congenital diseases
Congenital heart disease
Coronary vessels
Diagnosis
Genetic disorders
Heart diseases
Heart rate
Imaging systems
Lungs
Medical imaging
Medical research
Medicine, Experimental
Multidetector computer tomography
Pediatrics
Pulmonary arteries
Radiation
Right ventricular outflow tract
Tetralogy of Fallot
Veins & arteries
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Summary:Background Tetralogy of Fallot is the most common congenital cyanotic heart disease. Advances in surgical repair recently facilitate survival of the affected patients into adulthood with good quality of life. Despite imaging plays crucial role in diagnosis of TOF patients, no single diagnostic modality suffices for complete evaluation of TOF. Thus, different diagnostic tools should be used alone or in combination according to patient's clinical question. This study aims to find out the agreement between the echocardiography and MDCT in evaluation of TOF patients prior to surgical repair. Results Three-step approach used in scanning TOF patients. Firstly, classic TOF findings, MDCT was comparable to echocardiography in overriding aorta (k = 0.6), VSD (k = 0.8), RVH (k = 0.4), and sub valvular pulmonary stenosis (k = 0.6). Echocardiography is superior to MDCT in evaluation of valvular stenosis (k = 0.4). MDCT was superior to echocardiography in supravalvular pulmonary stenosis. Secondary, surgical relevant findings, McGoon ratio calculated in 94.2%, small and major APCs in 45.5% and 28.5% respectively, PDA in 35% and anomalous coronary artery in 5.1%. Thirdly, other TOF-associated anomalies, common: ASD (34.3%) and RAA (28.3%), and persistent LSVC (10.3%). Uncommon: situs ambiguous (2.5 %), PAPVR (1.2%), and IVC anomalies (3.8%). MDCT was superior to echocardiography in surgical relevant findings and other TOF-associated anomalies. Conclusion MDCT is a crucial imaging tool for extra cardiac evaluation of TOF patients prior to surgical repair.
ISSN:0378-603X
2090-4762
DOI:10.1186/s43055-021-00418-z