Name of the Procedure:

Computed Tomography (CT) of the Heart with Contrast for Evaluation of Cardiac Structure and Morphology in Congenital Heart Disease (including 3D Image Postprocessing, Assessment of Left Ventricular (LV) Cardiac Function, Right Ventricular (RV) Structure and Function)

Summary

This procedure involves using a specialized X-ray machine (CT scanner) to create detailed images of the heart. A contrast dye is injected to enhance the visibility of the heart structures. The images are processed to generate a 3D model, which helps evaluate the heart's anatomy and function, particularly in congenital heart disease.

Purpose

• Medical Condition: Congenital heart disease.
• Goals: To obtain detailed images of the heart's structure and function, assess any abnormalities in the heart chambers, and understand the overall cardiac morphology.

Indications

• Symptoms like shortness of breath, chest pain, or irregular heartbeats.
• Known or suspected congenital heart disease.
• Pre-surgical planning and post-operative evaluation.

Preparation

• Fasting: Generally, do not eat or drink for at least four hours before the procedure.
• Medication Adjustments: Follow specific instructions regarding current medications, particularly those affecting heart rate and kidney function.
• Diagnostic Tests: Blood tests to check kidney function, and sometimes a prior ECG.

Procedure Description

1. Initial Assessment: Patient undergoes initial examination and preparation in the imaging suite.
2. Contrast Injection: An intravenous (IV) line is placed for contrast dye injection.
3. Scanning: The patient lies on a CT scanner table, and images are captured while the contrast dye is injected to enhance visualization.
4. Image Processing: Advanced software is used for 3D image postprocessing.
5. Assessment: Detailed evaluation of LV and RV function and morphology using the processed images.

Duration

Typically takes about 30 to 60 minutes.

Setting

Typically performed in a hospital radiology department or specialized imaging center.

Personnel

• Radiologist
• Cardiac CT technician
• Nurse for IV insertion and monitoring
• Cardiologist for interpretation and clinical correlation

Risks and Complications

• Common Risks: Mild allergic reaction to contrast dye, slight discomfort from IV insertion.
• Rare Risks: Severe allergic reaction to contrast dye, contrast-induced nephropathy, and radiation exposure.

Benefits

• Provides detailed and accurate information on heart structure and function, aiding in diagnosis and treatment planning.
• Non-invasive with relatively quick recovery time.
• Offers clear 3D visualization of complex congenital heart defects.

Recovery

• Post-Procedure: Patient is monitored briefly for any adverse reactions to the contrast dye.
• Recovery Time: Immediate, no significant downtime.
• Follow-up: Instructions for any necessary follow-up appointments will be provided.

Alternatives

• Echocardiography: Non-invasive but may not provide as detailed images.
• Magnetic Resonance Imaging (MRI): No radiation exposure but longer and may not be feasible for all patients.
• Catheterization: Invasive but can provide functional information and allow for interventional treatment.

Patient Experience

• During the Procedure: Mild discomfort from the IV insertion; the contrast may cause a warm or metallic taste.
• After the Procedure: Generally minimal discomfort; most patients can resume normal activities shortly after.
• Pain Management: Typically, no significant pain, and comfort measures are provided during and after the scan.