Single ventricle physiology: Spectrum of CT findings

Congress:

ECR 2020

Poster Number:

C-05781

Type:

Educational Exhibit

Keywords:

Observational, Retrospective, Congenital, Contrast agent-intravenous, CT-Angiography, CT, Cardiac, Performed at one institution

Authors:

S. Kaushik¹, P. Gupta², R. AGARWAL³, S. K. Puri¹; ¹New Delhi/IN, ²New Delhi, De/IN, ³Amritsar/IN

DOI:

10.26044/ecr2020/C-05781

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-05781

Fig. 3: Algorithmic approach in SVP

Fig. 10: Unbalanced Atrioventricular septal defect. Complete atrioventricular septal...

Fig. 13: Right atrial isomerism:Bilateral symmetrical eparterial upper lobar bronchi...

Fig. 5: Tricuspid atresia.Axial CT showing fat in the atrioventricular groove...

Fig. 8: Double inlet left ventricle.Axial CT shows both right atrium (RA) and left...

Fig. 9: Double inlet right ventricle.CT images showing that both atrioventricular...

Learning objectives

Identify cardiac lesions that function physiologically as single ventricles. Describe the anatomical and imaging characteristics of pathologies resulting in single ventricle physiology(SVP). Understand the role of CT in the diagnostic evaluation of SVP.

Background

SVP is characterized by admixture of pulmonary and systemic venous blood at the atrial or ventricular level with associated atresia/hypoplasia of a cardiac valve or chamber. As a result: Ventricular output is the sum of pulmonary blood flow and systemic blood flow Distribution of systemic and pulmonary blood flow is dependent on the relative resistances to flow into the two parallel circuits.1 This physiology can exist in patients with one well-developed ventricle as well as in patients with two well-formed ventricles (Fig.1) and is explained...

Findings and procedure details

This retrospective study included 22 SVP patients (Figure2) who underwent CT between February to September 2019. All data was acquired on a 256 slice scanner. Nonionic contrast medium was given intravenously via 20–22 G catheter with power dual injector at a rate of 1.5–4 mL/s followed by a saline chaser.Exams started from the thoracic inlet level to below the diaphragm.Images were acquired using optimised FLASH protocol.The test bolus technique was used with 4-second delay time after the peak contrast enhancement of a region of interest...

Conclusion

SVP encompasses a spectrum of severe congenital heart lesions which show multiple anatomic variations but similar hemodynamic physiology.Cardiac CT accurately depicts many forms of SVP and is a robust noninvasive imaging alternative for comprehensive preoperative evaluation in patients with SVP.

Personal information and conflict of interest

S. Kaushik; New Delhi/IN - nothing to disclose P. Gupta; New Delhi, DE/IN - nothing to disclose S. K. Puri; New Delhi, DELHI/IN - nothing to disclose R. Agarwal; Amritsar/IN - nothing to disclose

References

1.DiNardo J. Physiology of single ventricle, birth and beyond. Conferencias magistrales C. 2010;33:S275-S277. 2.Anders M. Single ventricle physiology - functionally univentricular heart, parallel circulation. Don't Forget The Bubbles. 2013 3.Lapierre C, Déry J, Guérin R, Viremouneix L, Dubois J, Garel L. Segmental Approach to Imaging of Congenital Heart Disease. RadioGraphics. 2010;30(2):397-411.