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Imaging the heart in adult congenital heart disease
  1. Consultant Paediatric Cardiologist,
  2. Birmingham Children’s Hospital NHS Trust,
  3. Steelhouse Lane,
  4. Birmingham B4 6NH, UK

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Over the past two decades most congenital cardiac lesions have become amenable to surgical repair. The trend is to perform more anatomical types of repair at an earlier age. In addition, older patients, who were previously only palliated, present for corrective surgical interventions. Surgical repair is seldom curative and patients will generally require close follow up throughout life.1 ,2 The total number of adolescent and adult patients with congenital heart disease is steadily increasing and will peak over the next decade. This poses great demands for the provision of dedicated clinical services, which depend on sophisticated imaging techniques.

Common pitfalls

The use of any imaging method in the assessment of congenital heart disease has to be carefully planned. Investigations should be carried out along the standardised segmental approach used to describe congenital cardiac lesions.3 The results obtained by the various techniques are operator dependent. Frequently, incomplete or unsatisfactory information is acquired. This is commonly a result of poor understanding of the underlying anatomy (congenital or postsurgical), misinterpretation of the findings, or poor image information, either because of the wrong choice of technique used or because of technical problems.

Ideally studies should be undertaken only with detailed knowledge of the underlying anatomy; the most likely residual or acquired lesions should be excluded or identified; the information required for any potential surgical intervention obtained; and the strengths and limitations of the imaging technique used understood. Thus, detailed imaging studies in adults with congenital heart disease often benefit from multidisciplinary cooperation.



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