Catheterization findings did not alter the planned surgical strategy (0%, 95% CI 0-10.9%) in pediatric patients with single-ventricle physiology evaluated before Fontan completion.
Observational (n=32)
No
Does cardiac computed tomography angiography provide comparable anatomical and hemodynamic information to conventional catheter angiography before Fontan completion in pediatric patients with single-ventricle physiology?
Cardiac CTA provides comprehensive and concordant anatomical evaluation prior to Fontan completion, suggesting it may serve as a valuable, less invasive alternative to routine catheter angiography for surgical planning.
Background: In congenital heart disease patients with single-ventricle physiology, accurate anatomical and hemodynamic evaluation prior to the Fontan completion procedure is critical for surgical planning and long-term outcomes. Although conventional catheter angiography (CCA) remains the reference standard for hemodynamic evaluation, cardiac computed tomography angiography (CTA) has emerged as an increasingly valuable tool for anatomical assessment in the preoperative evaluation of Fontan candidates. Objective: To compare the anatomical and hemodynamic information provided by CTA and CCA before Fontan completion and to evaluate their complementary roles in the preoperative assessment of pediatric patients with single-ventricle physiology. Methods: This single-center, retrospective study included 32 patients with single-ventricular physiology who underwent staged palliation and Fontan completion. All patients underwent TTE and CCA. Twenty-three patients also underwent cardiac CTA with three-dimensional reconstruction. Anatomical and hemodynamic findings obtained from CTA and CCA were compared, with particular focus on extracardiac anatomy, collateral vessels, and findings relevant to surgical planning. Results: Cardiac CTA showed concordant detection of clinically significant anatomical findings identified by CCA, while providing a more comprehensive assessment of extracardiac anatomy. While CCA remained superior for hemodynamic assessment, CTA provided more comprehensive evaluation of extracardiac anatomy. In this cohort, catheterization findings did not alter the planned surgical strategy (0%, 95% CI 0–10.9%). Conclusions: CTA may provide valuable anatomical information for preoperative assessment and surgical planning; however, larger prospective multicenter studies are required before less invasive pre-Fontan evaluation strategies can be considered.
Çevlik et al. (Tue,) conducted a observational in Single-ventricle physiology (n=32). Cardiac computed tomography angiography (CTA) vs. Conventional catheter angiography (CCA) was evaluated on Alteration of planned surgical strategy by catheterization findings (95% CI 0-10.9). Catheterization findings did not alter the planned surgical strategy (0%, 95% CI 0-10.9%) in pediatric patients with single-ventricle physiology evaluated before Fontan completion.