Congenital heart disease frequency in children undergoing MDCT angiography; a 4-year tertiary care hospital experience from Kabul, Afghanistan.

Abstract

Objectives:Echocardiography and cardiac angiography are two main imaging modalities used for evaluating congenital heart diseases (CHDs). Evaluation of CHDs is now possible with Multidetector CT (MDCT) angiography in Afghanistan. To the best of researchers' knowledge, no published data is available on frequency of CHDs among children undergoing chest MDCT angiography in Afghanistan; hence, this study is first of its nature to be conducted in this context. To describe the frequency of CHDs among children who underwent chest MDCT angiography in radiology department at French Medical Institute for Mothers and Children (FMIC) from April 2010 to July 2014.Methods & materials:A retrospective, cross-sectional descriptive study was conducted at radiology department FMIC in Kabul, Afghanistan. The study population consisted of all paediatric patients (aged 1 day–17 years) who underwent chest MDCT angiography at radiology department FMIC from April 2010 to July 2014. All examinations were performed in arterial phase by 128 slice Siemens scanner after intravenous administration of non-ionic water-soluble contrast material (Omnipaque 350) at a volume of 2 ml/Kg. CT setup included non-electrocardiogram gated CT, CT dose index 5–10 and dose–length product 120–200, with post-processing following initial scan. CT reports were reviewed from Radiology Information System. Data collection tool was developed and data were analysed using SPSS v. 22. Frequencies and proportion were calculated for various CHDs.Results:A total of 942 cases of contrast enhanced chest MDCT examinations were performed during this period. Out of these, 212 cases with CHDs were recruited, from which 29 cases were excluded because of undergoing previous surgical procedures or had incomplete CT reports. Remaining 183 cases (n = 183) of CHDs were included for further analysis. A total of 107 patients (58.5%) were male and 76 (41.5%) were female. The patients aged 1 day–17 years (mean age 4.47 + 4.76 standard deviation). A total of 87 patients (47.5%) had solitary anomalies while 96 patients (52.5%) had more than one defect. In terms of location, 20 cases (10.9%) were isolated intracardiac anomalies, 116 cases (63.4%) were isolated extracardiac anomalies and 47 cases (25.7%) had mixed intra- and extracardiac anomalies.Conclusion:Given the frequency, it is clear that CHDs is a complex health problem in Afghan paediatric population. MDCT angiography can be considered as a non-invasive, readily available diagnostic tool in evaluation of complex cardiac anomalies after initial evaluation.Advances in knowledge:MDCT evaluation of CHD as an alternative to echo/angiography has become more important in a country where there is severe shortage of interventional cardiologists.