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Misra et al. Vessel Plus 2022;6:32 https://dx.doi.org/10.20517/2574-1209.2021.104 Page 9 of 13

Figure 6. Axial (A) and sagittal (B) slice of cardiac CT imaging of a 54-year-old woman with repaired TOF with absent pulmonary valve
who had a transcatheter pulmonary valve placement. Dilated main and branch pulmonary arteries are typically seen in this phenotype of
TOF.

anatomy in the presence of stents or other metallic items. Presence of new intimal proliferation, stent
fracture, aneurysm/pseudoaneurysm can be easily detected.

Aorto-pulmonary collaterals:
Due to high spatial resolution with this technique, it heals itself to the accurate assessment of aorto-
pulmonary collaterals.

Airway and lungs:
Airway anatomy in relation to the heart/great vessels can also be assessed. Needless to say that other organs
in the chest, including lung parenchyma, pleural space, and other mediastinal structures, can also be
assessed.

Coronaries:
Delineation of coronary arteries origin and course in relation to right ventricular outflow tract would be
crucial in the context of percutaneous valve placement or surgical intervention and can be accurately done.
Assessment of coronary arteries for stenosis is gaining more significance as patients with repaired TOF are
getting older and reaching the age range for acquired coronary artery disease.

Volumetric assessment:
ECG gated multiphase data set can be acquired using advanced MDCT, which will allow measurement of
end-diastolic and end-systolic volumes of right and left ventricles and their respective stroke volume,
cardiac output, and ejection fraction. These measurements cannot be reliably obtained with a close
correlation with CMR but remain the gold standard for this purpose.