The main role for a cardiac catheterization is now in the rare patient with TAPVC who requires interventional cardiac palliation before complete repair, such as atrial septostomy or stent placement [62,63]. Arteriography Pulmonary There is no relevant literature to support the use of pulmonary arteriography in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE. CT Heart Function and Morphology CT heart function and morphology is indicated when MRI is limited by the presence of significant metallic susceptibility artifact obscuring the heart or due to the presence of MR-incompatible pacemakers/devices. Congenital or Acquired Heart Disease CTA Chest CTA chest is useful for the anatomical definition of anomalous pulmonary venous drainage anatomy. CTA chest can also be used in the critical setting of possible obstructed TAPVC to define the level and degree of obstruction, especially in children with infracardiac and mixed TAPVC [64,65]. In obstructed infradiaphragmatic TAPVC, CTA chest can correctly depict the drainage site of the common pulmonary vein, stenosis of the vertical vein, and the course of the atypical vessel into the systemic vein, especially outside the usual echocardiographic windows [66]. In other types of TAPVC and PAPVC, CTA chest has excellent spatial resolution and can help define the complete anomalous drainage pathways of the pulmonary veins. CTA chest has the added advantage of being an excellent modality for evaluating the pulmonary parenchyma to look for associated pulmonary and bronchovascular abnormalities (eg, pulmonary sequestration, hypoplastic lung, abnormal bronchial branching) [64,67,68]. CTA Coronary Arteries There is no relevant literature to support the use of CTA coronary arteries in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE.
Congenital or Acquired Heart Disease. The main role for a cardiac catheterization is now in the rare patient with TAPVC who requires interventional cardiac palliation before complete repair, such as atrial septostomy or stent placement [62,63]. Arteriography Pulmonary There is no relevant literature to support the use of pulmonary arteriography in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE. CT Heart Function and Morphology CT heart function and morphology is indicated when MRI is limited by the presence of significant metallic susceptibility artifact obscuring the heart or due to the presence of MR-incompatible pacemakers/devices. Congenital or Acquired Heart Disease CTA Chest CTA chest is useful for the anatomical definition of anomalous pulmonary venous drainage anatomy. CTA chest can also be used in the critical setting of possible obstructed TAPVC to define the level and degree of obstruction, especially in children with infracardiac and mixed TAPVC [64,65]. In obstructed infradiaphragmatic TAPVC, CTA chest can correctly depict the drainage site of the common pulmonary vein, stenosis of the vertical vein, and the course of the atypical vessel into the systemic vein, especially outside the usual echocardiographic windows [66]. In other types of TAPVC and PAPVC, CTA chest has excellent spatial resolution and can help define the complete anomalous drainage pathways of the pulmonary veins. CTA chest has the added advantage of being an excellent modality for evaluating the pulmonary parenchyma to look for associated pulmonary and bronchovascular abnormalities (eg, pulmonary sequestration, hypoplastic lung, abnormal bronchial branching) [64,67,68]. CTA Coronary Arteries There is no relevant literature to support the use of CTA coronary arteries in the evaluation of known or suspected anomalous pulmonary venous return with inadequate evaluation after TTE.