From: Complex adult congenital heart disease on cross-sectional imaging: an introductory overview
ACHD type | Contrast injection protocol | Range | Sequence | Additional comments |
---|---|---|---|---|
Repaired TOF | Triphasic injection protocol with acquisition timed to aortic opacification | Thoracic inlet to diaphragm | Coronaries or RVOT/pulmonary valve assessment: prospectively ECG gated | Retrospectively ECG gated if irregular rhythm |
Repaired D-TGA | Triphasic injection protocol with acquisition timed to aortic opacification A dedicated coronary artery angiogram protocol with ECG gating if assessing the ostia for post-arterial switch procedures | Thoracic inlet to diaphragm | Prospectively ECG gated if assessing the coronary ostia | A triphasic protocol is not suitable for detecting baffle leaks. In this case, a biphasic protocol is advised A delayed phase study is advised if assessing for superior limb baffle obstruction Retrospectively ECG gated if irregular rhythm |
Fontan circuit | Options include: Single contrast phase, delayed phase acquisition protocol Biphasic contrast, single delayed phase acquisition protocol Single contrast phase, biphasic acquisition protocol (if coronary imaging needed) | Thoracic inlet to diaphragm Extend to upper abdomen if liver disease is suspected | Prospectively ECG gated if assessment of small structures needed (e.g. for small intracavitary thrombi) | Upper extremity IV access only is most commonly used. Consider upper and lower extremity IV access Retrospectively ECG gated if irregular rhythm |