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Coronary artery anomalies on preoperative cardiac CT in children with tetralogy of Fallot or Fallot type of double outlet right ventricle: comparison with surgical findings

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Abstract

Coronary artery anomalies on preoperative cardiac CT have not been systematically compared with surgical findings in a large cohort of tetralogy of Fallot and Fallot type of double outlet right ventricle. This study was conducted to evaluate incidence and diagnostic accuracy of preoperative cardiac CT for identifying detailed coronary artery anatomy in these patients. Coronary artery anatomy on preoperative cardiac CT exams in 318 children with tetralogy of Fallot or Fallot type of double outlet right ventricle were reviewed and compared with surgical findings. Incidences of total and surgically critical coronary artery anomalies, concordance rate between cardiac CT and surgical findings, and diagnostic accuracy of cardiac CT were assessed. In addition, the types of surgical modifications for surgically critical coronary artery anomalies were reviewed. The incidences of total and surgically critical coronary artery anomalies were 8.5% (27/318) and 5.0% (16/318), respectively. The concordance rate between cardiac CT and surgical findings was 95.0% (302/318). The diagnostic accuracy of cardiac CT was 96.9% (308/318). In surgically significant coronary artery anomalies, tailored and careful right ventriculotomy was done in 13 cases, placement of a right ventricle–pulmonary artery conduit in two, and unroofing of the right coronary artery in one. Preoperative cardiac CT may be useful in identifying coronary artery anatomy in children with tetralogy of Fallot or Fallot type of double outlet right ventricle.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Hyun Woo Goo

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Correspondence to Hyun Woo Goo.

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All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Goo, H.W. Coronary artery anomalies on preoperative cardiac CT in children with tetralogy of Fallot or Fallot type of double outlet right ventricle: comparison with surgical findings. Int J Cardiovasc Imaging 34, 1997–2009 (2018). https://doi.org/10.1007/s10554-018-1422-1

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  • DOI: https://doi.org/10.1007/s10554-018-1422-1

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