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Table 1 Summary of suggested CT protocols by repaired defect

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

  1. ECG, electrocardiogram; RVOT, right ventricular outflow tract