Multi-detector computed tomography angiographic evaluation of right ventricular outflow tract obstruction and other associated cardiovascular anomalies in tetralogy of Fallot patients

Purpose
To evaluate various types of right ventricular outflow tract obstruction associated with tetralogy of Fallot (TOF) with emphasis on the abnormality of pulmonary arterial system and other associated cardiovascular anomalies using computed tomography (CT) angiography.

Material and methods
We retrospectively evaluated 184 consecutive previously diagnosed TOF patients who underwent CT angiography in our department.

Results
Infundibular with pulmonary valvular stenosis was the most common type of stenosis (47.28%) found, followed by isolated infundibular stenosis (34.23%). Isolated abnormality of both right and left pulmonary arteries was also noted. Right side aortic arch (23.91%) was the most common associated abnormality followed by double superior vena cava (9.78%).

Conclusions
TOF is associated with various types of right ventricular outflow tract obstruction ranging from infundibular narrowing to isolated narrowing of right or left pulmonary arteries and is also associated with various other congenital abnormalities of the cardiovascular system. CT angiography is an excellent imaging modality, which provides comprehensive analysis of various abnormalities associated with TOF.