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Cited by 7Congenital Heart Disease StudiesCardiac Imaging and DiagnosticsCongenital heart defects research

Complex adult congenital heart disease on cross-sectional imaging: an introductory overview

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Saleh, Mahdi, Gendy, David, Voges, Inga, Nyktari, Eva, Arzanauskaite, Monika·2022·Insights into Imaging
DOI 10.1186/s13244-022-01201-yPMC PMC9038985
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Abstract

Congenital heart disease is the most common group of congenital pathology. Over the past few decades, advances in surgical treatment have resulted in a rising population of adult patients with repaired complex congenital heart disease. Although the quality of life has greatly improved, a significant proportion of morbidities encountered in clinical practice is now seen in adults rather than in children. These patients often have significant haemodynamic pathophysiology necessitating repeat intervention. CT and MRI are excellent imaging modalities, which help elucidate potential complications that may need urgent management. Although imaging should be performed in specialised centres, occasionally patients may present acutely to emergency departments in hospitals with little experience in managing potentially complex patients. The purpose of this article is to provide an introductory overview to the radiologist who may not be familiar with complex congenital heart disease in adult patients. This educational review has three main sections: (1) a brief overview of the post-operative anatomy and surgical management of the most common complex conditions followed by (2) a discussion on CT/MRI protocols and (3) a review of the various complications and their CT/MRI findings.

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  • After surgical correction, CCT can be used for postoperative follow-up, to quantify ventricular volumes, detect postsurgical complications, plan repeat interventions, and is preferred for assessing graft material, calcifications, or stents in the conduit when echocardiography and CMRI are not indicated or suboptimal.

    “After surgical correction, CCT can be used for postoperative follow-up to assess the success of the procedure and detect any potential complications or residual defects [64]. In postoperative patients, CCT can be used to quantify ventricular volumes, detect postsurgical complications, and plan for repeat interventions. CCT represents a practical alternative when echocardiography and CMRI are not”

    From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [65]

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  • After complete repair of TOF, common postoperative complications such as RVOT dilatation, residual VSD, residual or recurrent RVOT stenosis, residual or recurrent PA stenosis, conduit stenosis, aortic dilation, stents, and implanted devices can be easily highlighted by CCT.

    “After complete repair of TOF, common postoperative complications such as RVOT dilatation, residual VSD, residual or recurrent RVOT stenosis, residual or recurrent PA stenosis, conduit stenosis, aortic dilation, stents, and implanted devices could be easily highlighted by CCT, as well as the anatomical assessment prior to transcatheter pulmonary valve replacement planning or redo sternotomy [61,64,”

    From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [65]

    The ‘Repaired TOF’ section lists RVOT dilatation and obstruction, residual VSD and pulmonary artery stenosis, and conduit stenosis as complications after repair. The ‘CT in complex ACHD’ section describes CT as high-resolution and potentially preferable when stents or implanted devices degrade MRI images. But the paper discusses MRI for assessing most of the listed TOF complications and does not establish that CCT easily highlights all of them or identify aortic dilatation as a repaired-TOF complication. (LLM, conf=0.86)

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Authors
Saleh, M., Gendy, D., Voges, I., Nyktari, E., & Arzanauskaite, M.
Affiliations
  • Liverpool Heart and Chest Hospital (GB)
  • University Hospital Schleswig-Holstein (DE)
Corresponding author
Saleh, Mahdi
ORCID
Venue
Insights into Imaging
Publisher
Springer Science and Business Media LLC
Published
2022-04-25
Volume
13
Issue
1
Pages
78-78
ISSN
1869-4101 (ISSN-L)
DOI
10.1186/s13244-022-01201-y
PMC
PMC9038985
OpenAlex
W4224861309
Cited by
7
References
61
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 1
FWCI
0.20
Type
journal article
Language
en
Open access
Licence
Locations
  • Insights into Imaging (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
Keywords
complex congenital heart disease, adult congenital heart disease, cross-sectional imaging, CT protocols, MRI protocol, surgical management, postoperative complications, emergency department management

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