Unique application of multislice computed tomography in adults with congenital heart disease

Purpose: Adults with congenital heart disease ( CHD) form a growing population of patients requiring coronary artery assessment. In light of their increased incidence of coronary anomalies and need for reoperations, it is important to define their coronary anatomy. The purpose of this studywas to define the spectrum of coronary artery anatomies and feasibility of coronary artery delineation in adults with CHD using 16- and 64- slice computed tomography angiography. Materials and methods: Coronary multislice computed tomography ( MSCT) examinations performed in adults with CHD between 2004 and 2005 were reviewed with institutional review board approval. Informed consent was not required. In addition to image quality, the following coronary parameters were evaluated by analysis of axial, multiplanar reformatted, and volume- rendered images: ( 1) relationship to great arteries, ( 2) ostia number and location, ( 3) proximal course, ( 4) length of vessel seen, and ( 5) dominance. Results: Eighty- five examinations in adults with CHD adults were identified. The relationship of the great vessels, number and location of the coronary ostia, and proximal course of the coronaries could be identified in all studies. Coronary anomalies were detected in 16 ( 19%) subjects. The entire coronary tree was visible in 77 ( 91%) of subjects. Conclusions: MSCT provides detailed, noninvasive assessment of complex coronary artery anatomy in adults with CHD. MSCT should be considered a useful modality in the assessment of these patients, as it does not require arterial access and provides detailed 3- dimensional anatomic information that has important implications for long- term management. (C) 2006 Elsevier Ireland Ltd. All rights reserved.