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Utility of computed tomographic angiography in the pre-operative planning for initial and repeat congenital cardiovascular surgery

Published online by Cambridge University Press:  29 March 2010

Alexander R. Ellis ,
Denise Mulvihill ,
Scott M. Bradley  and
Anthony M. Hlavacek
Alexander R. Ellis*
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of the King’s Daughters, Eastern Virginia Medical School, Norfolk, Virginia, United States of America Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina, United States of America
Denise Mulvihill
Affiliation:
Department of Radiology, Division of Pediatric Radiology, Medical University of South Carolina, Charleston, South Carolina, United States of America
Scott M. Bradley
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, United States of America
Anthony M. Hlavacek
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina, United States of America
*
Correspondence to: Dr A. R. Ellis, MD, MSc, Children’s Hospital of the King’s Daughters, Eastern Virginia Medical School, 601 Children’s Lane, Norfolk, Virginia 23507, United States of America. Tel: +1 757 668 7214; Fax: +1 757 668 8225; E-mail: EllisAR@EVMS.edu
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Abstract

Objective

To investigate the utility of computed tomographic angiography as an adjunctive imaging modality before congenital cardiac surgery.

Design

We evaluated 33 patients who underwent a pre-operative computed tomographic angiogram. They were classified according to the anatomic site of repair. Post-operatively, the surgeon completed a questionnaire assessing the utility of the study.

Results

Computed tomographic angiography was found to be either “essential” or “very useful” for pre-operative planning in 94% of the patients. Specifically, the scan was consistently useful for procedures involving the aorta (14/15, 93%) or the pulmonary veins (4/4, 100%) and obviated pre-operative catheterisations in 14 patients (42%). Furthermore, when compared with other diagnostic groups, computed tomographic angiography determined the need for peripheral cannulation in patients undergoing re-operations (6/7; 86%, p = 0.02).

Conclusions

Computed tomographic angiography was found to be useful in the pre-operative planning of virtually all patients undergoing repair of congenital cardiac malformations, regardless of diagnosis. Specifically, the studies were essential in select populations, such aortic arch or pulmonary vein repairs, and helped to determine cannulation sites for repeat operations while significantly reducing the need for invasive imaging.

Keywords

Congenital cardiac diseasealternative imaging modalityperioperative care
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 3 , June 2010 , pp. 262 - 268
Copyright
Copyright © Cambridge University Press 2010

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