Evaluation of Extracardiac Intrathoracic Vascular Anomalies on CT Angiography In 254 Patients being Evaluated for Congenital Heart Disease and Comparison with Echocardiography

Abstract

Background: To evaluate the advantage of CT Angiography (CTA) in diagnosis of extra cardiac vascular and non-vascular abnormalities in patients of congenital heart disease. Patients and Methods: This is a retrospective study wherein two hundred fifty four consecutive patients from January 2017 to December 2019 with known congenital heart disease who were referred for CTA as a part of their regular clinical work up were included. Findings of Echocardiography (ECHO) were also recorded. Results: The vascular anomalies on CTA were found in 191 patients giving an incidence of 75.1% with MAPCAs showed the highest incidence (34.61%). On ECHO vascular anomalies were found in 97 patients giving an incidence of 38.18%. Incidence of associated non-cardiovascular anomalies detected on CTA came out to be 16.4% The most common detected congenital heart disease was TOF on both CTA and ECHO. Although ASD and VSD are diagnosed on Echo, CTA was performed in these cases as a part of the comprehensive workup. CTA significantly outperformed ECHO in the detection of vascular anomalies eg. PDA and COA. Rests of the CHD detection were equal in CTA and ECHO. Conclusion: As patients of congenital heart diseases also present with a wide range of associated extra cardiac vascular findings which range from non-significant to those affecting the clinical outcome of patients. Assessment of extra-cardiac vessels is mandatory at the time of performing these studies since these findings are important for giving a complete diagnosis and for treatment planning in some cases. CTA also detects incidental non-cardiovascular anomalies which can affect the treatment planning of that patient.