Complementary Roles of Cardiac Computed Tomography Angiography and Catheter Angiography Before Fontan Completion in Patients with Single-Ventricle Physiology: A Single-Center Experience
Journal of Clinical Medicine, cilt.15, sa.13, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 13
- Basım Tarihi: 2026
- Doi Numarası: 10.3390/jcm15135286
- Dergi Adı: Journal of Clinical Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Fontan procedure, multimodality imaging, computed tomography angiography, catheter angiography
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.