title: Computed tomographic angiography in tetralogy of Fallot.
abstract: Echocardiography is often inadequate for imaging tetralogy of Fallot, prompting cineangiography. This study prospectively evaluated multidetector computed tomographic angiography for preoperative evaluation of tetralogy of Fallot in 112 consecutive patients. Forty-eight had nonconfluent or hypoplastic pulmonary arteries (mean z-score, -2; range, -11.1-0.13) permitting only palliative or no surgery; 64 had adequate pulmonary artery anatomy (mean z-score, 0.59; range, -2.53-3.4) allowing total repair. The surgical data of 50 patients who underwent total correction were compared with transthoracic echocardiography and multidetector computed tomographic angiography findings. Multidetector computed tomographic angiography tended to reveal unsuspected collaterals and coronary abnormalities besides outlining the right ventricular outflow tract and pulmonary artery branches. The branch pulmonary artery diameter z-score was the most important determinant of surgical strategy, with the worst figures being associated with no surgical options or palliative surgery, and the best figures leading to corrective surgery. The mean radiation dose was 3.45 mSv. Multidetector computed tomographic angiography is a powerful supplement to echocardiography in the preoperative evaluation of tetralogy of Fallot.
authors.affiliation: Department of Pediatric Cardiology, The Madras Medical Mission, Chennai, India.
authors.forename: Pankajkumar Ashok
authors.initials: PA
authors.lastname: Kasar
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Ravikumar
authors.forename: Roy
authors.initials: R
authors.lastname: Varghese
authors.forename: Monika
authors.initials: M
authors.lastname: Kotecha
authors.forename: Jesudian
authors.initials: J
authors.lastname: Vimala
authors.forename: Raghavan Nair Suresh
authors.initials: RN
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography