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Cardiovascular CT for evaluation of single-ventricle heart disease: risks and accuracy compared with interventional findings

Published online by Cambridge University Press:  11 September 2017

B. Kelly Han ,
Marnie Huntley ,
David Overman ,
Dawn Witt ,
David Dassenko ,
Ross F. Garberich  and
John R. Lesser
B. Kelly Han*
Affiliation:
Advanced Cardiac Imaging, Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota, United States of America Division of Pediatric Cardiology and Cardiothoracic Surgery, The Children’s Heart Clinic, Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, United States of America
Marnie Huntley
Affiliation:
Division of Pediatric Cardiology and Cardiothoracic Surgery, The Children’s Heart Clinic, Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, United States of America
David Overman
Affiliation:
Division of Pediatric Cardiology and Cardiothoracic Surgery, The Children’s Heart Clinic, Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, United States of America
Dawn Witt
Affiliation:
Advanced Cardiac Imaging, Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota, United States of America
David Dassenko
Affiliation:
Division of Pediatric Cardiology and Cardiothoracic Surgery, The Children’s Heart Clinic, Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, United States of America
Ross F. Garberich
Affiliation:
Advanced Cardiac Imaging, Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota, United States of America
John R. Lesser
Affiliation:
Advanced Cardiac Imaging, Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota, United States of America
*
Correspondence to: B. K. Han, MD, The Children’s Heart Clinic, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, United States of America. Tel: 612 813 8800; Fax: 612 813 8825; E-mail: khan@chc-pa.org
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Abstract

Objective

We sought to evaluate the risk and image quality from cardiovascular CT in patients across all stages of single-ventricle palliation, and to define accuracy by comparing findings with intervention and surgery.

Methods

Consecutive CT scans performed in patients with single-ventricle heart disease were retrospectively reviewed at a single institution. Diagnosis, sedation needs, estimated radiation dose, and adverse events were recorded. Anatomical findings, image quality (1–4, 1=optimal), and discrepancy compared with interventional findings were determined. Results are described as medians with their 25th and 75th percentiles.

Results

From January, 2010 to August, 2015, 132 CT scans were performed in single-ventricle patients of whom 20 were neonates, 52 were post-Norwood, 15 were post-Glenn, and 45 were post-Fontan. No sedation was used in 76 patients, 47 were under minimal or moderate sedation, and nine were under general anaesthesia. The median image quality score was 1.2. The procedural dose–length product was 24 mGy-cm, and unadjusted and adjusted radiation doses were 0.34 (0.2, 1.8) and 0.82 (0.55, 1.88) mSv, respectively. There was one adverse event. No major and two minor discrepancies were noted at the time of 79 surgical and 10 catheter-based interventions.

Conclusions

Cardiovascular CT can be performed with a low radiation exposure in patients with single-ventricle heart disease. Its accuracy compared with that of interventional findings is excellent. CT is an effective advanced imaging modality when a non-invasive pathway is desired, particularly if cardiac MRI poses a high risk or is contraindicated.

Keywords

Cardiac CTsingle-ventricle CHDrisk
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 1 , January 2018 , pp. 9 - 20
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Copyright
© Cambridge University Press 2017 

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