ROLE OF MULTI SLICE COMPUTED TOMOGRAPHIC ANGIOGRAPHY AS AN ADDITIONAL TOOL TO TRANSTHORACIC ECHOCARDIOGRAPHY FOR DIAGNOSIS OF PULMONARY VEIN ANOMALIES

Abstract

ABSTRACT Objective: To determine the role and safety of CT angiography as an additional tool to transthoracic echocardiography in the diagnosis of pulmonary vein anomalies. Methodology: All patients with suspected anomalous pulmonary venous connections from first October 2011 to 30 May 2013 were included in the study. Results: A total number of 99 patients with suspected pulmonaryanomalous venous connections or pulmonary vein stenosis were included in the study. Among them 54(54.5%) were male, while 45(45.4%) were females. Mean age was 28.19± 34.1 months ( 2 days to 33 years). The mean weight was 9.1±6.37kg (2.5kg to 62kg).Sedation with oral chloral hydrate was used in majority of patients i.e 72 (72.7 %), 13(13.1%) required no sedation, 9(9.1%) required midazolam, 4(4%) required morphine while only one patient required ketamine. The sensitivity of transthoracic echocardiography for partial anomalous pulmonary venous connection (PAPVC) was 91.6% and specificity was 96%.The sensitivity of transthoracic echocardiography for total anomalous pulmonary venous connection (TAPVC) was 86.5% and specificity was 100%. The sensitivity of transthoracic echocardiography for isolated pulmonary vein stenosis was 66.6% and specificity was 100%. We were unable to assess pulmonaryvenous drainage on transthoracic echocardiography in 38(38.4%) patients. Conclusion: CT angiography is a useful additional tool to transthoracic echo in assessment of pulmonary venous drainage in patients with limited echo windows and other technically difficult echocardigrams.