DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20190937

MSCT imaging of various shunts and grafts in post operative cases of congenital heart diseases

Dinesh L. Patel, Yashpal R. Rana, Megha M. Sheth, Samir G. Patel, Milin N. Garachh, Kamal K. Parikh

Abstract


Background: Multi-slice computed tomography (MSCT) plays an important role in clinical practice in assessing post-operative patients with complex CHD when echocardiography is not contributory.  Despite the great capabilities of MR imaging for anatomic and functional assessment of the heart, it is time-consuming and may require a lengthy period of patient sedation; hence its use in seriously ill or uncooperative patients is often limited. CT has the advantages of widespread availability and short acquisition times. It is imperative for a radiologist to be aware of various palliative as well as corrective procedures and their various imaging findings. Aim of this article is to demonstrate and make one aware of various checklists and imaging findings in paediatric patients who have undergone various shunts and grafts at our tertiary cardiac care centre, their immediate as well as long term complications.

Methods: We studied a total of 100 paediatric patients (<12 years old), who had undergone some sort of palliative or corrective shunt or graft placement, on MSCT during the period 2014 to 2018 at our tertiary cardiac care centre.

Results: We try to outline details of various shunts and grafts used in congenital heart diseases correction, MSCT technique and imaging appearances and appearances of abnormal post-operative findings.

Conclusions: Advances in computed tomography (CT) scanners and electrocardiographic gating techniques have resulted in superior image quality of the aorta and pulmonary arteries for evaluating postoperative congenital heart disease. MSCT is an excellent non-invasive modality for post-operative evaluation of various shunts and grafts.


Keywords


Congenital heart disease, MSCT, Shunts and grafts

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References


Tomasian A, Malik S, Shamsa K, Krishnam MS. Congenital heart diseases: post-operative appearance on multi-detector CT-a pictorial essay. European radiology. 2009 Dec 1;19(12):2941-9.

Leschka S, Oechslin E, Husmann L, Desbiolles L, Marincek B, Genoni M, et al. Pre-and postoperative evaluation of congenital heart disease in children and adults with 64-section CT. Radiographics. 2007 May;27(3):829-46.

Alkhulaifi AM, Lacour-Gayet F, Serraf A, Belli E, Planche C. Systemic pulmonary shunts in neonates: early clinical outcome and choice of surgical approach. Ann Thorac Surg. 2000;69:1499-504.

Rodriguez E, Soler R, Fernandez R, Raposo I Postoperative imaging in cyanotic congenital heart diseases: part I, normal findings. AJR Am J Roentgenol. 2007;189:1353-60.

Amato JJ, Marbey ML, Bush C, Galdieri RJ, Cotroneo JV, Bushong J. Systemic-pulmonary polytetrafluoroethylene shunts in palliative operations for congenital heart disease. Revival of the central shunt. J Thorac Cardiovasc Surg. 1988;95(1):62-9.

Ahmed S, Johnson PT, Fishman EK, Zimmerman SL. Role of multidetector CT in assessment of repaired tetralogy of Fallot. Radiographics. 2013 Jun 29;33(4):1023-36.

Pizarro C, Malec E, Maher KO, Januszewska K, Gidding SS, Murdison KA, et al. Right ventricle to pulmonary artery conduit improves outcome after stage I Norwood for hypoplastic left heart syndrome. Circulation. 2003 Sep 9;108(10_suppl_1):II-155.

Mavroudis C, Backer CL, Deal BJ. Venous shunts and the Fontan circulation in adult congenital heart disease. In: Gatzoulis MA, Webb GD, Daubeney PEF (eds) Diagnosis and management of adult congenital heart disease. Churchill Livingstone, Edinburgh;2003:79-84.

Yeong M, Loughborough W, Hamilton M, Manghat N. Role of cardiac MRI and CT in Fontan circulation. J Congenital Cardiol. 2017 Dec;1(1):8.

Dillman JR, Hernandez RJ. Role of CT in the evaluation of congenital cardiovascular disease in children. AJR. 2009;192(5):1219-31.

Banderker E, Pretorius E, De Decker R. The role of cardiac CT angiography in the pre-and postoperative evaluation of tetralogy of Fallot. S Afr J Rad. 2015;19(2).

Nabo MM, Hayabuchi Y, Inoue M, Watanabe N, Sakata M, Kagami S. Assessment of modified Blalock-Taussig shunt in children with congenital heart disease using multidetector-row computed tomography. Heart and vessels. 2010 Nov 1;25(6):529-35.