Francisco Contreras BS, Presenter: Nothing to Disclose

Nishant D. Parekh MD, Abstract Co-Author: Nothing to Disclose

Jeffrey Michael Levsky MD, PhD, Abstract Co-Author: Nothing to Disclose

Nadine Chouietier, Abstract Co-Author: Nothing to Disclose

Linda Broyde Haramati MD, MS, Abstract Co-Author: Investor, OrthoSpace Ltd Investor, Kryon Systems Ltd Spouse, Board Member, Bio Protect Ltd Spouse, Board Member, OrthoSpace Ltd Spouse, Board Member, Kryon Systems Ltd

To systematically examine if and how cardiothoracic CT and MRI guided management in a consecutive cohort of adults with tetralogy of Fallot (TOF) over a 10-year period at our urban, inner-city academic medical center.  

56 consecutive adults (30 men, mean age 35.26, range 18-69 years) with TOF at our inner-city academic medical center who underwent cardiothoracic imaging with CT or MRI were retrospectively identified by searching the radiology database 1/03-1/13. 77% (36/47) of patients with documented ethnicity were minorities: Black (19), multiracial (14), Asian (3). Medical charts were reviewed for surgical history, clinical presentation, indication for imaging, diagnoses and management. 84% (47/56) had one or more remote prior cardiac surgeries including transannular patch (30), infundibulectomy (24), right ventricle to pulmonary artery conduit (13) and Blalock-Taussig shunt (6). 13% (7/56) died during the follow-up period.

21 patients underwent chest CT for symptoms including chest pain, dyspnea, hemoptysis and cough. 35 patients underwent cardiac MRI to evaluate ventricular volumes and function, pulmonary regurgitation and pulmonary artery flow. Imaging guided treatment in 66% (37/56) and did not alter management in the remaining 34% (19/56). Of these, 57% (21/37) underwent open or minimally-invasive surgery and 43% (16/37) received medical management. The most common surgical interventions were pulmonary valve replacement 33% (7/21) and right ventricle to pulmonary artery conduit revision 24% (5/21) for increased right ventricular volumes and worsening clinical symptoms. Medical therapy included treatment for heart failure in 75% (12/16) and pneumonia in 25% (4/16).  

Cardiothoracic CT and MR imaging were valuable in guiding treatment in a multi-ethnic, diverse, inner-city cohort of adults with TOF, impacting surgical decision-making and medical management.  

Management of a multi-ethnic diverse group of adults with TOF was guided by chest CT and cardiac MR.  

Contreras, F, Parekh, N, Levsky, J, Chouietier, N, Haramati, L, Cardiothoracic CT and MR Guide Management in a Diverse Multi-Ethnic Cohort of Adults with Tetralogy of Fallot.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011707.html