Author + information
- Gentian Lluri, MD, PhD∗,
- Jamil A. Aboulhosn, MD†,
- John M. Moriarty, MD‡,
- J. Paul Finn, MD‡,
- Stefan G. Ruehm, MD, PhD‡,
- Matthew J. Budoff, MD§,
- Gabriel Vorobiof, MD∗ and
- Eric H. Yang, MD∗∗ ()
- ∗Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California
- †Ahmanson-UCLA Adult Congenital Heart Disease Center, University of California at Los Angeles, Los Angeles, California
- ‡Section of Cardiovascular Imaging, Department of Radiology, University of California at Los Angeles, California
- §Division of Cardiology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, California
- ↵∗Reprint requests and correspondence:
Dr. Eric Yang, UCLA Cardiovascular Center, University of California at Los Angeles, 100 Medical Plaza, Suite 630, Los Angeles, California 90095.
In various subsets of tetralogy of Fallot (TOF) patients, the anatomic heterogeneity, myriad of potential surgical palliations, and the potentially associated intracardiac and extracardiac anomalies encountered must be taken into consideration when imaging a patient with TOF. Multidetector cardiac computed tomography (MDCT), with its superior spatial and temporal resolution, has become a valuable modality in evaluating the complex anatomic findings associated with both unrepaired (Figure 1) and repaired TOF patients that traditional echocardiography may have difficulty visualizing or if there are contraindications (i.e., rhythm devices) to magnetic resonance imaging (1–3). MDCT can be used to evaluate the patency of surgical palliative shunt placement (Figure 2) and for long-term sequelae and complications (Figure 3) including pulmonary regurgitation, right ventricular outflow obstruction, conduit stenosis, aortic root dilation with aortic regurgitation, left-sided failure, and right ventricular hypertrophy and failure. Finally, intraprocedural 3-dimensional computed tomography combined with fluoroscopic overlay has shown encouraging early results and may play an important future role in complex congenital and structural interventions (Figure 4, Online Video 1). In conclusion, due to the increasing prevalence and improved overall survival of TOF patients, there is a growing need for safe, reliable, and low-cost diagnostic imaging modalities, with MDCT offering accurate anatomic assessment for the complex spectrum of these patients.
For a supplemental video, please see the online version of this paper.
Dr. Aboulhosn serves as a consultant for General Electric Healthcare. Dr. Vorobiof serves on the Speakers Bureau of and is a consultant for Lantheus Medical Imaging; and is a consultant for St. Jude Medical and Toshiba American Medical Systems. Dr. Budoff has received research grants from General Electric Healthcare. Dr. Ruehm has received research grants from Siemens. Dr. Finn has received research grants from Siemens and Bracco Diagnostics. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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