Cor Vasa 2013, 55(5):e434-e438 | DOI: 10.1016/j.crvasa.2013.07.003

CT angiography in Fontans with implanted stents

Marek Kardoš^a,*, Juraj Mikuláš^b, Ivan Vulev^b, Jozef Mašura^a

^a Oddelenie funkčného vyšetrovania, Detské kardiocentrum, Bratislava, Slovensko

^b Oddelenie diagnostickej a intervenčnej rádiológie, Národný ústav srdcových a cievnych chorôb, Bratislava, Slovensko

Background: CT angiography is used as a non-invasive method in the evaluation of patients with Fontan circulation. For good visualization of patients having undergone the Fontan operation the optimal scan timing and adequate intravenous route is important.
Purpose: The aim of this study was to confirm that computer tomography is a very good tool for assessment of patients after Fontan procedure with implanted stents in pulmonary arteries or in fenestration.

Material and methods: Six patients with Fontan circulation and implanted stent in left pulmonary artery or in fenestration underwent CT angiography. The CT angiography was successfully performed to all patients. For homogenous enhancement of Fontan pulmonary arteries and Fontan tract we decided to use 1-minute delay scan with right antecubital application of contrast agent. The optimal enhancement was evaluated at the right pulmonary artery (RPA), left pulmonary artery (LPA), and Fontan tract. Optimal enhancement was defined when evaluation of stent was possible.

Results: Optimal enhancement when the stent was possible to evaluate intraluminally was achieved in seven CT examinations. The Bland-Altman test demonstrated good agreement between readers.

Conclusions: This study demonstrates that CT angiography is a fast, accurate and reproducible method in the evaluation of patients with Fontan circulation, and implanted stent in pulmonary arteries or in fenestration.

Keywords: Computer angiography; Fontan circulation; Optimal enhancement; Stents

Received: June 5, 2013; Revised: July 12, 2013; Accepted: July 14, 2013; Published: October 1, 2013  Show citation