Table 3.

Common Uses of Cardiac CT in Specialist Congenital Heart Disease Centers

Ventricular quantification in patients with a contraindication to CMR
Abandoned pacemaker leads, epicardial pacemaker systems*
Anatomic evaluation in patients with CMR “blind spots”
Ferromagnetic implant artifact: coarctation and pulmonary artery stents, embolization coils, and Fontan fenestration closure devices
Anatomic evaluation in patients who tolerate CMR poorly
Developmental stage or cognitive impairment limits scan time or breath holding
Physiological instability limiting scan time or breath holding
Coronary anatomic evaluation
Congenital: anomalous coronaries, coronary fistula
Post surgical reimplantation (Ross, Bentall, and Jatene)
Screening for acquired coronary artery disease in patients with symptoms or before surgery
Determine RV to pulmonary artery conduit relationship to coronaries before Melody valve implant
Determine coronary sinus anatomy before cardiac resynchronization therapy
Evaluation of cannula position and for thrombus post ventricular assist device implant
Exclusion of intracardiac thrombus prior to cardioversion
Simultaneous evaluation of lung parenchymal pathology and extracardiac structures
  • CHD indicates congenital heart disease; CMR, cardiac magnetic resonance; CT, computed tomography; and RV, right ventricle.

  • * Magnetic resonance imaging safety protocols differ between centers. Local consultation is recommended in CHD patients with potential contraindications to CMR.

  • CT may be considered for exclusion of intracardiac thrombus in emergent or unstable patients and those with contraindications to transesophageal echocardiogram.