Abstract
PurposeTo determine the value of dual-source computed tomography (DSCT) in depicting the morphological characteristics and diagnosing the associated malformations for patients with transposition of the great arteries (TGA) before surgery.Materials and methodsTwenty-five patients with TGA who underwent DSCT and transthoracic echocardiography (TTE) examination were retrospectively reviewed. The morphological types of TGA, the spatial relationship between the pulmonary artery and the aorta, as well as coronary artery-associated abnormalities were assessed by DSCT. In contrast to TTE, the diagnostic accuracy of associated malformations on DSCT were analyzed and calculated with reference to surgical or digital subtraction angiography (DSA) findings. Effective doses (EDs) were also calculated.ResultsAmong the 25 patients, 12 (48%) had ventricular septal defects and left ventricular outflow tract stenosis. Sixteen patients (16/25, 64%) had great arteries with an oblique spatial relationship on DSCT. In addition, we found seven patients (7/25, 28%) with coronary artery malformation, including five with an abnormal coronary origin and two with signs of a myocardial bridge. According to DSA or surgical findings, DSCT was superior to TTE in demonstrating extracardiac anomalies (sensitivity, anomalies of great vessels: 100% vs. 93.33%, other anomalies: 100% vs. 46.15%). The mean estimated ED for those aged <10 years was <2 mSv (1.59 ± 0.95 mSv).ConclusionsDSCT can achieve an overall assessment of patients with TGA, including any associated malformations as well as the identification of the spatial relationship of the great arteries. DSCT can therefore be considered as an alternative imaging modality for surgical decision making.
Highlights
Transposition of the great arteries (TGA) is a rare anomaly with an estimated prevalence of 5%–7% among all congenital heart diseases (CHD) [1]
According to digital subtraction angiography (DSA) or surgical findings, dual-source computed tomography (DSCT) was superior to transthoracic echocardiography (TTE) in demonstrating extracardiac anomalies
DSCT can achieve an overall assessment of patients with TGA, including any associated malformations as well as the identification of the spatial relationship of the great arteries
Summary
Transposition of the great arteries (TGA) is a rare anomaly with an estimated prevalence of 5%–7% among all congenital heart diseases (CHD) [1]. The main clinical manifestations of TGA are cyanosis and dyspnea [2]. TGA has a normal atrioventricular connection but a ventriculoarterial discordance, in which the pulmonary artery arises from the morphological left ventricle and the aorta arises from the morphological right ventricle (RV) [3]. TGA is considered to account for a variety of organ damage in infants because of the decreased level of brain oxygen [4,5]. It is vital that the choice of operation is based on the knowledge of the spatial relationship of the great arteries and the coronary artery abnormalities. Accurate and comprehensive evaluation of TGA and associated abnormalities is critical before surgery
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
