Coronary Arteries Anomalies by CT in Children With CHD

April 19, 2024 updated by: Rehab Mohamed Rashed Gad, Assiut University

Detection of Coronary Arteries Anomalies by Computed Tomography Angiography in Children With Congenital Heart Disease

Delineate coronary artery anatomy and detection of coronary anomalies in children with complex cardiac anomalies by cardiac CT-angiography before total surgical correction.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Congenital heart diseases (CHD) form an important spectrum of pediatric diseases causing significant morbidity and mortality. Due to inter-related embryology of the heart and development of the coronary arteries, there is a great variability in coronary artery patterns in patients with CHD [1].

The spectrum of coronary artery anomalies ranges from benign / incidental findings to significant cardiac morbidity in infancy or increased risk of cardiac sudden death in childhood or adolescence [2]. Abnormalities can be found in the coronary artery origin, course, and size or the number of vessels. Isolated anomalies of coronary artery origins, in those without structural heart disease, had an estimated incidence of 0.7% [3]. Coronary artery anomalies have a higher incidence in children with congenital heart disease, ranging from an incidence of 5% in those with coarctation [4] to 7% in tetralogy of Fallot [5] and up to 37% in single-ventricle physiologies [6]. Identifying these anomalies has become an important part of the preoperative evaluation to avoid inadvertent injury and has been shown to be effectively diagnosed with modern CT techniques compared to surgical visualization and catheter angiography [6,7]. System of coronary artery origin and branching is of great help to surgeons who dedicate their efforts to the treatment of congenital heart disease [8].

Coronary artery imaging in children is frequently challenging due to small size, high heart rates, and motion artifacts from cardiac pulsation, respiration, and the patients themselves, which results in technical or procedural difficulties [9].

Imaging modalities for evaluating coronary arteries in children include echocardiography, conventional invasive angiography, magnetic resonance imaging (MRI), and computed tomography (CT). Transthoracic echocardiography is widely used as the primary imaging approach. However, it is impaired by its limited ability to fully characterize coronary anatomy, by poor acoustic windows, and by operator dependency [10].

Magnetic resonance imaging (MRI), also provides information on cardiac anatomy and function, allowing 3-dimensional coronary artery imaging without the use of ionizing radiation.However, it is impaired by long acquisition time requiring prolonged patient cooperation, which may not be possible in children without general anesthesia, and bylimited spatial resolution which makes coronary evaluation beyond originassessment difficult [11].

Computed tomography (CT) angiography is often the firstline diagnostic modality of choice for noninvasive imaging of the coronary arteries in both adults and children. CT is rapidly acquired and can be performed in the setting of multiple support devices. Compared with cardiac MRI and transthoracic echocardiography, CT provides excellent spatial resolution with superior visualization of the entire course of the coronary arteries [12].

Recent advances in CT technology have allowed for dramatic decreases in radiation dose while maintaining theexcellent spatial resolution that allows for detailed anatomical evaluation [13].

Coronary artery abnormalities in children may be congenital or acquired. Congenital anomalies include a complex group of disorders occurring as isolated conditions or in the spectrum of congenital heart disease.Acquired coronary anomalies are mainly secondary to Kawasaki disease or surgery when congenital heart disease repair involves coronary manipulation. Increasing evidence is supporting the role of CT in general for coronary evaluation of these patients [14,15]. The Coronary artery anomalies are grouped under four subtypes, i.e. anomalies of origin and course, intrinsic anomalies of coronaries, anomalies of termination, and anomalous anastomotic vessels [16]. Coronary artery abnormalities are more common in patients with congenital heart disease. Even when clinically irrelevant, these lesions may become important as they may affect surgical repair. Unambiguous coronary artery imaging is therefore mandatory in this situation and, especially when echocardiography is not conclusive ,CT should be employed to avoid unnecessary invasive procedures, even in the neonatal period. The most common conditions to consider in this setting include tetralogy of Fallot and (dextro-)transposition of the great arteries[17].

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

-Children aged from 1 day to 18 years old with congenital heart disease and undergoing surgical correction.

Description

Inclusion Criteria:

  • Children aged from 1 day to 18 years old with congenital heart disease and undergoing surgical correction.

Exclusion Criteria:

  • 1-Children had isolated coronary anatomy anomalies.

    2-Children had medical coronary artery disease i.e. Kawasaki disease.

    3-Children with CHD and not candidate for surgical correction .

    4-Children with CHD with past history of cardiac surgery.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Detection of coronary arteries anomalies by computed tomography angiography in children with congenital heart disease
Time Frame: Baseline
Delineate coronary artery anatomy and detection of coronary anomalies in children with complex cardiac anomalies by cardiac CT-angiography before total surgical correction.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2025

Primary Completion (Estimated)

January 1, 2026

Study Completion (Estimated)

December 31, 2029

Study Registration Dates

First Submitted

April 19, 2024

First Submitted That Met QC Criteria

April 19, 2024

First Posted (Actual)

April 24, 2024

Study Record Updates

Last Update Posted (Actual)

April 24, 2024

Last Update Submitted That Met QC Criteria

April 19, 2024

Last Verified

April 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CAA by CT in children with CHD

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Cardiac Congenital Defects

Clinical Trials on Cardiac CT

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Canada

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe