Limits...
Volumetric Computed Tomography Angiography in the Evaluation of Mediastinal Fluid Collections following Congenital Cardiac Surgery.

Roest AA, Roelofs J, Hazekamp MG, Rijlaarsdam ME, Geleijns J, Kroft LJ - Case Rep Pediatr (2013)

Bottom Line: We present 3 patients with 4 causes of mediastinal fluid collection after congenital cardiac surgery in this extended case report.Volumetric computed tomography played an essential role in diagnosing causes and extent, relevant to subsequent management.Recent advances in volumetric computed tomography allow fast and accurate imaging of cardiovascular and extravascular structures in children with acceptable radiation dose, providing a powerful imaging tool for the evaluation of complications after congenital cardiac surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Cardiology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

ABSTRACT
We present 3 patients with 4 causes of mediastinal fluid collection after congenital cardiac surgery in this extended case report. Volumetric computed tomography played an essential role in diagnosing causes and extent, relevant to subsequent management. Recent advances in volumetric computed tomography allow fast and accurate imaging of cardiovascular and extravascular structures in children with acceptable radiation dose, providing a powerful imaging tool for the evaluation of complications after congenital cardiac surgery.

No MeSH data available.


Related in: MedlinePlus

Pseudoaneurysm after surgical repair. ECG-triggered volumetric contrast-enhanced cardiac CT (AquilionONE, Toshiba medical systems) acquired during systole within a single heart beat at a heart rate of 109 beats per minute, in 2 years female patient. Image in transverse orientation. Large precardiac contrast collection (CC) with open connection (two-sided arrow) to the right ventricle (RV), at the site of RV patch (P). CT differential diagnosis was RV patch aneurysm or pseudoaneurysm. Surgery confirmed pseudoaneurysm. Dose-length product of the CT scan was 18.2 mGy·cm. Correction factor for chest CT at 100 kV for 2 years age was 0.044 mSv·mGy−1·cm−1; effective dose E was 1.4 mSv.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3569889&req=5

fig4: Pseudoaneurysm after surgical repair. ECG-triggered volumetric contrast-enhanced cardiac CT (AquilionONE, Toshiba medical systems) acquired during systole within a single heart beat at a heart rate of 109 beats per minute, in 2 years female patient. Image in transverse orientation. Large precardiac contrast collection (CC) with open connection (two-sided arrow) to the right ventricle (RV), at the site of RV patch (P). CT differential diagnosis was RV patch aneurysm or pseudoaneurysm. Surgery confirmed pseudoaneurysm. Dose-length product of the CT scan was 18.2 mGy·cm. Correction factor for chest CT at 100 kV for 2 years age was 0.044 mSv·mGy−1·cm−1; effective dose E was 1.4 mSv.

Mentions: A 2-year-old girl was admitted because of mediastinal fluid observed during routine echocardiography. The girl was known with hypoplastic left heart syndrome after Norwood-procedure with placement of a Sanoconduit between the right ventricle and pulmonary arteries, followed by bidirectional cavopulmonary connection with closure of the Sanoshunt. To assess the nature and extent of the mediastinal fluid collection, CT imaging was performed. On CT, a large precardiac fluid collection with open connection to the right ventricle was found (Figure 4). CT differential diagnosis was right ventricular patch aneurysm or pseudoaneurysm. At surgery, pseudoaneurysm formation was confirmed at the site of previous anastomosis of the Sanoshunt to the right ventricle that had been closed by a patch. The pseudoaneurysm was removed. Currently, the patient is scheduled for completion of the Fontan circulation by connecting the inferior caval vein to the right pulmonary artery.


Volumetric Computed Tomography Angiography in the Evaluation of Mediastinal Fluid Collections following Congenital Cardiac Surgery.

Roest AA, Roelofs J, Hazekamp MG, Rijlaarsdam ME, Geleijns J, Kroft LJ - Case Rep Pediatr (2013)

Pseudoaneurysm after surgical repair. ECG-triggered volumetric contrast-enhanced cardiac CT (AquilionONE, Toshiba medical systems) acquired during systole within a single heart beat at a heart rate of 109 beats per minute, in 2 years female patient. Image in transverse orientation. Large precardiac contrast collection (CC) with open connection (two-sided arrow) to the right ventricle (RV), at the site of RV patch (P). CT differential diagnosis was RV patch aneurysm or pseudoaneurysm. Surgery confirmed pseudoaneurysm. Dose-length product of the CT scan was 18.2 mGy·cm. Correction factor for chest CT at 100 kV for 2 years age was 0.044 mSv·mGy−1·cm−1; effective dose E was 1.4 mSv.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569889&req=5

fig4: Pseudoaneurysm after surgical repair. ECG-triggered volumetric contrast-enhanced cardiac CT (AquilionONE, Toshiba medical systems) acquired during systole within a single heart beat at a heart rate of 109 beats per minute, in 2 years female patient. Image in transverse orientation. Large precardiac contrast collection (CC) with open connection (two-sided arrow) to the right ventricle (RV), at the site of RV patch (P). CT differential diagnosis was RV patch aneurysm or pseudoaneurysm. Surgery confirmed pseudoaneurysm. Dose-length product of the CT scan was 18.2 mGy·cm. Correction factor for chest CT at 100 kV for 2 years age was 0.044 mSv·mGy−1·cm−1; effective dose E was 1.4 mSv.
Mentions: A 2-year-old girl was admitted because of mediastinal fluid observed during routine echocardiography. The girl was known with hypoplastic left heart syndrome after Norwood-procedure with placement of a Sanoconduit between the right ventricle and pulmonary arteries, followed by bidirectional cavopulmonary connection with closure of the Sanoshunt. To assess the nature and extent of the mediastinal fluid collection, CT imaging was performed. On CT, a large precardiac fluid collection with open connection to the right ventricle was found (Figure 4). CT differential diagnosis was right ventricular patch aneurysm or pseudoaneurysm. At surgery, pseudoaneurysm formation was confirmed at the site of previous anastomosis of the Sanoshunt to the right ventricle that had been closed by a patch. The pseudoaneurysm was removed. Currently, the patient is scheduled for completion of the Fontan circulation by connecting the inferior caval vein to the right pulmonary artery.

Bottom Line: We present 3 patients with 4 causes of mediastinal fluid collection after congenital cardiac surgery in this extended case report.Volumetric computed tomography played an essential role in diagnosing causes and extent, relevant to subsequent management.Recent advances in volumetric computed tomography allow fast and accurate imaging of cardiovascular and extravascular structures in children with acceptable radiation dose, providing a powerful imaging tool for the evaluation of complications after congenital cardiac surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Cardiology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

ABSTRACT
We present 3 patients with 4 causes of mediastinal fluid collection after congenital cardiac surgery in this extended case report. Volumetric computed tomography played an essential role in diagnosing causes and extent, relevant to subsequent management. Recent advances in volumetric computed tomography allow fast and accurate imaging of cardiovascular and extravascular structures in children with acceptable radiation dose, providing a powerful imaging tool for the evaluation of complications after congenital cardiac surgery.

No MeSH data available.


Related in: MedlinePlus