Right Heart Catheterization in Tetralogy of Fallot

Right Heart Catheterization in Tetralogy of Fallot With the availability of high resolution echocardiographic images and Doppler echocardiography, role of cardiac catheterization has come down in tetralogy of Fallot and other congenital heart diseases in general. Important risks for cardiac catheterization in a deeply cyanotic infant are the chance of precipitation of a cyanotic spell and thrombotic strokes due to hemoconcentration. Chance of precipitating a cyanotic spell are more when pulmonary angiography is attempted through the already narrow right ventricular outflow tract. Hemocontration is due to the diuresis following contrast angiography, which can be prevented by adequate pre and post procedure hydration. Diagnostic cardiac catheterization may be needed especially in tetralogy of Fallot with pulmonary atresia, to assess the pulmonary anatomy, including size and distribution of peripheral pulmonary arteries. Major aortopulmonary collateral arteries (MAPCAs) can be delineated by angiography during right heart catheterization. The image shows a MAPCA originating from right internal mammary artery. Finding out the origin and insertion of MAPCAs is important prior to surgical repair of tetralogy of Fallot. Another important role is for detection of coronary anomalies, which can also be seen on echocardiogram sometimes. Magnetic resonance imaging is another way of documenting coronary anomalies. MAPCA originating from right internal mammary artery McGoon’s ratio is...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions Source Type: blogs