E1915. Complex Forms of Tetralogy of Fallot and Associated Anomalies
To study the morphology of complex forms of tetralogy of Fallot and associated anomalies by cardiac CT angiography.
Materials and Methods:
48 patients diagnosed as tetralogy of Fallot by echocardiography and referred for preoperative cardiac CT angiography were evaluated. The procedure and objectives of performing the study were explained to the patients and written consent was taken. The study was performed on 128 slice Dual Energy Siemens CT scanner.
The study revealed 26 patients having imaging features of classic tetralogy of Fallot and 22 patients having features of complex forms of tetralogy of Fallot. The latter group showed male to female ratio of 1.2:1 and the ages ranged between 21 days and 18 years with a mean of 4 years. Cardiac CT angiography revealed 5 patients having tetralogy of Fallot with atrial septal defect, 4 patients having tetralogy of Fallot with absent pulmonary valve, 10 patients having tetralogy of Fallot with pulmonary atresia and 3 patients having double outlet right ventricle (Fallot type). Additionally, 13 patients with aortic arch anomalies, 1 patient with muscular ventricular septal defect, 1 patient with doubly committed subaortic and subpulmonic ventricular septal defect, 2 patients with non confluent branched pulmonary arteries, 5 patients with patent ductus arteriosus,1 patient with ductal diverticula, 16 patients with dilated and tortuous major aortopulmonary collaterals, 2 patients with double superior vena cava and 3 patients with coronary artery anomalies were also noted.
The present results prompt routine preoperative cardiac CT angiography for evaluation of morphology of complex forms and associated anomalies in patients with tetralogy of Fallot. Cardiac CT angiography provides an ideal alternative to invasive cardiac catheterization as well as overcoming the limitations of echocardiography in detailed evaluation of tetralogy of Fallot.