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Pediatric CT, coronary anomaly, post-surgical control

Control of surgically corrected Bland-White-Garland syndrome in a 4 month old boy with 144 bmp

Author: Christoph R Becker, MD, Section chief body CT, Department of Clinical Radiology, Klinikum Grosshadern, Munich, Germany

History

A 4 month old newborn with Bland-White-Garland syndrome (LAD connected to the pulmonary artery instead of the ascending aorta) underwent surgical correction. Dual Source CT was performed for post-operative control. No beta blockers were applied.


Diagnosis

The LAD was successfully reinserted onto the aorta. A gore tex graft with 6 mm in diameter was in between aorta and LAD.


Comments

Despite the very high heart rate of 144 bpm and the small size of the patient’s heart, DSCT enables an excellent motion free visualization of the tunnel that was placed to connect the LAD with the aorta. The tunnel is well displayed and completely patent. No thrombus formation is seen. Good LAD run off after the tunnel can be assessed suggesting sufficient blood flow.

VRT of the thorax of a 4 month old boy with a heart rate of 144 bmp where a cardiac DSCT was performed for post-operative control. Arrow indicates the implanted gore tex tunnel.
The 6 mm tunnel is well displayed and completely patent in the above thin MIP image.
Above thin MIP image demonstrates how DSCT enables the motion free display even of the peripheral segments of the LAD, despite the very high heart rate of 144 bpm.

Examination Protocol

Scanner SOMATOM Definition
Scan area entire Thorax
Scan length 109 mm
Scan time only 4.87 s
Scan direction cranio-caudal
Heart rate 144bpm
ACV mono
kV 120 kV
mAs 120 mAs/rot
Rotation time 0.33 s
Slice collimation 64x0.6 mm
Slice width 0.75 mm
Pitch 0.73 (automatically adjusted)
Reconstruction increment 0.5 mm
CTDI 6.3 mGy
Kernel B26f
Contrast Imeron
Volume 12 ml
Flow rate 2 ml / s
Start delay using Care Bolus

 

Date: 2006-11-16


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