Congenital heart disease other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Keri Shafer, M.D. [2], Atif Mohammad, M.D., Priyamvada Singh, MBBS

Other Imaging Findings

Cardiac Catheterization

Cardiac catheterization could be diagnostic or therapeutic. These modalities are not very frequently used nowadays due to availability of better, easy and safe non invasive diagnostics tools such as echocardiography. The indications for their use are:

• To differentiate whether the etiology is cardiac or pulmonary (if uncertainty prevails even after non-invasive methods)

• Catheterization could be done if it is central for treatment. For e.g. in cases of complete transposition of great arteries, a cardiac catheterization with balloon atrial septostomy helps to prevent rapid deterioration in the child.

2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Recommendations for Cardiac Catheterization

When diagnosis, prognosis, or care call for a more exact characterization of anatomy than is possible with improved noninvasive imaging, cardiac catheterization continues to be a common tool. Also required when pressures and resistances must be calculated, or when physiological or anatomic simulation is required to allow for extra calculation or anatomic visualization. Cardiac catheterization may offer special details that are not consistently available from other diagnostic techniques.

Class I

1.Cardiac catheterization (hemodynamic and/or angiographic) in patients with ACHD AP classification II and III, or interventional cardiac catheterization in patients with ACHD AP classification I to III should be performed by, or in collaboration with, cardiologists with expertise in ACHD. (Level of Evidence C-LD)

Class IIa

1.In patients with a low or intermediate pretest probability of coronary artery disease (CAD), use of CT coronary angiography is reasonable to exclude significant obstructive CAD when cardiac catheterization has significant risk or because of patient preference. (Level of Evidence: B-NR)

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