Arteriography Coronary with Ventriculography Catheter angiography is a useful modality for the evaluation of the coronary arteries and measurement of atrial and ventricular pressure. It provides direct measurements of RVOT gradients, dynamic assessment of regurgitant flow, and hemodynamic assessment of diastolic dysfunction [9]. Coronary angiography is performed in patients with suspected anomalous coronary artery to delineate the course of the coronary artery before interventions in the RVOT [10,11]. This could be important in the setting of percutaneous intervention, because one concern is coronary artery compression with inflation of a balloon-expandable stent in the RVOT when performing PVR percutaneously. Arteriography Pulmonary Cardiac catheterization is performed in patients only when alternative measures cannot accurately assess the RV and pulmonary artery anatomy or hemodynamics noninvasively. However, angiographic evaluation of PR severity is complicated by the fact that catheter position across the PV may influence the angiographic severity. It allows for simultaneous catheter-guided therapeutic interventions such as pulmonary artery balloon dilatation and stent placement and PVR [12]. CT Heart Function and Morphology A common deficiency of TTE imaging in repaired TOF is imaging of the branch pulmonary arteries. Multidetector CT provides accurate assessment of the anatomy of the branch pulmonary arteries, including within stented segments. It provides detailed anatomic evaluation of the heart and RVOT as well as other vascular abnormalities, such as pulmonary artery aneurysms or pseudoaneurysms, associated coronary anomalies, or aortic dilation [13,14]. Performing electrocardiogram (ECG) gating permits dynamic assessment of the RVOT for percutaneous pulmonary valve planning, and measurement of RV and left ventricular (LV) volume and function.
Congenital or Acquired Heart Disease. Arteriography Coronary with Ventriculography Catheter angiography is a useful modality for the evaluation of the coronary arteries and measurement of atrial and ventricular pressure. It provides direct measurements of RVOT gradients, dynamic assessment of regurgitant flow, and hemodynamic assessment of diastolic dysfunction [9]. Coronary angiography is performed in patients with suspected anomalous coronary artery to delineate the course of the coronary artery before interventions in the RVOT [10,11]. This could be important in the setting of percutaneous intervention, because one concern is coronary artery compression with inflation of a balloon-expandable stent in the RVOT when performing PVR percutaneously. Arteriography Pulmonary Cardiac catheterization is performed in patients only when alternative measures cannot accurately assess the RV and pulmonary artery anatomy or hemodynamics noninvasively. However, angiographic evaluation of PR severity is complicated by the fact that catheter position across the PV may influence the angiographic severity. It allows for simultaneous catheter-guided therapeutic interventions such as pulmonary artery balloon dilatation and stent placement and PVR [12]. CT Heart Function and Morphology A common deficiency of TTE imaging in repaired TOF is imaging of the branch pulmonary arteries. Multidetector CT provides accurate assessment of the anatomy of the branch pulmonary arteries, including within stented segments. It provides detailed anatomic evaluation of the heart and RVOT as well as other vascular abnormalities, such as pulmonary artery aneurysms or pseudoaneurysms, associated coronary anomalies, or aortic dilation [13,14]. Performing electrocardiogram (ECG) gating permits dynamic assessment of the RVOT for percutaneous pulmonary valve planning, and measurement of RV and left ventricular (LV) volume and function.