Evaluate the use of coronary CTA as an initial assessment for determining Right Ventricle
Dependent Coronary Circulation (RVDCC) in neonates with Pulmonary Atresia with Intact
Ventricular Septum (PA IVS). Retrospective review of cases with coronary CTA and compare
with available catheter angiography, pathology, surgical reports, and outcomes from
Mar 2015 to May 2022. In our cohort of 16 patients, 3 were positive for RVDCC, confirmed
by pathologic evaluation, and there was concordance for presence or absence of RVDCC
with catheter angiography in 5 patients (4 negatives for RVDCC, 1 positive). Clinical
follow up for the 8 patients that underwent RV decompression had no clinical evidence
of myocardial ischemia. Our findings suggest that coronary CTA is reliable as first-line
imaging for determination of RVDCC in neonates with PA IVS. These findings, if supported
by further prospective study, may reserve invasive coronary angiography for cases
with diagnostic uncertainty or at the time of necessary transcatheter interventions.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
PA IVS (Pulmonary Atresia with Intact Ventricular Septum), RVDCC (Right Ventricular Dependent Coronary Circulation), CTA (Computed Tomographic Angiography), LAD (Left Anterior Descending), ECG (Electrocardiographic Gating), MPR (Multiplanar Reconstructions), ECMO (Extracorporeal Membrane Oxygenation), mBTS (modified Blalock Taussig Shunt), BSA (Body Surface Area), PDA (Patent Ductus Arteriosus), RF (Radiofrequency), BDG (Bidirectional Glenn shunt), CMR (Cardiac Magnetic Resonance), 2V (Two Ventricle (biventricular repair)), 1V (One Ventricle (single ventricle palliation))To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 13, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
WTSA Meeting Presentation
Funding: There was no funding for this study.
Conflict of interest: The authors have no financial disclosures.
IRB approval was obtained on November 10, 2021, IRB # 21-4728.
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Copyright
© 2022 Elsevier Inc. All rights reserved.
