Claudia Pujol Salvador, Julia Lemmer, Farid Pouralikhan, Michael Porner, Vasiliki Trigas, Siegrun Mebus, Stefan Martinoff and Harald Kaemmerer
Multidetector Computer Tomography in Congenital Heart Disease
Objectives: Extracardiac pathology is common in patients with congenital heart disease. Multidetector computer tomography can be a useful tool for detection. To date, there are only scarce reports regarding “incidental“ non-cardiac findings during cardiac computer tomography. Aims of this study were to analyze indications, implementation, and timing of multidetector computer tomography in patients with congenital heart disease. Materials and methods: During 32 months, 195 patients were retrospectively included in our analysis. Type of congenital heart disease, timing of the procedure (preoperative, postoperative, follow-up, native), explored areas (thorax, cranium, abdomen, sternum, neck and extremities), and indications were disclosed. Results: During the study period, 250 scans were performed in 195 patients. Mean age was 23.0 ± 17.1 years (minimum 3 days, maximum 73 years); 48.2% were younger than 20 years. Almost 71% had undergone reparative cardiovascular surgery. Complex congenital heart disease (26.5%) and left-ventricular heart obstructions (22.5%) were the most common defects referred to computer tomography. In 19.5% of patients more than one scan was necessary. The tests were most performed in the postoperative/ postinterventional (36%) and long-term follow-up (30.4%) periods. Most indications focused on the thorax (55.5%), particularly when cardiovascular complications were suspected. Assessment of cerebral pathology was the second most frequent indication (25%). Final diagnosis was achieved in 94% of cases. Conclusions: Extracardiac pathology is frequent in patients with congenital heart disease, mainly in younger patients and with complex cardiac pathology. Multidetector computer tomography is a very useful tool when cardiovascular complications or cerebral pathology is suspected. Therefore, a good cooperation between radiologists and congenital cardiologists is mandatory.
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