Multidetector computed tomographic angiography in evaluation of neonates with suspected extracardiac congenital heart disease: experience in Vilnius University Hospital Santariškių Klinikos

The aim of this study was to determine the frequency of extracardiac pathology in neonatal patients with suspected congenital heart disease referred to undergo multidetector computed tomography (MDCT) angiography in Vilnius University Hospital Santariskiu Klinikos. The safety of MDCT angiography (intravenous contrast media volume injected, scanning time and exposure to ionising radiation) was also evaluated.

Patients and Methods: During the period of 2006-2012, in Vilnius University Hospital Santariskiu Klinikos 186 pediatric patients were referred to undergo MDCT angiography of whom 71 were neonates with suspected complex congenital heart disease (CHD) and extracardiac pathology.

Results: Sixty nine (97.2%) of referred neonates were found to have extracardiac pathology (36 had extracardiac vascular pathology only, 4 - extracardiac non-vascular pathology only and 29 - both extracardiac vascular and non-vascular pathology). In 47 patients diagnosis of extracardiac pathology was verified intraoperatively. Remainder (n = 24) of the group were not operated (12 patients died because of hemodynamic instability and inoperable complex CHD, 9 patients were scheduled for later surgery, in 3 patients surgery was not indicated). Mean contrast media volume used was 4.18±1.03 ml, mean scanning time was 1.07±0.77 s and mean effective radiation dose was 2.8± 0.69 mSv. No adverse reactions or complications were observed.

Conclusions: MDCT angiography is accurate and safe method in diagnosis of complex congenital heart disease with extracardiac pathology.