Multidetector computed tomography in the adolescent and young adult with congenital heart disease

As a result of improved postoperative management and transcatheter interventions, the number of adults with congenital heart disease in the United States has grown exponentially. Consequently, noninvasive imaging has taken an essential role in the evaluation of this patient population. Although standard noninvasive imaging tools such as transthoracic echocardiography and cardiovascular magnetic resonance may be invaluable to this group, occasionally there may be contraindications to their use or limitations in their utility. Multidetector computed tomography (MDCT) has only recently been used in the assessment of the adult with congenital heart disease. The ever-increasing availability of MDCT, along with its increased spatial and temporal resolution and rapidity of postprocessing, makes this an attractive first-choice to study this complex group. A successful scan requires familiarity with the complexity of the underlying anatomy and prior palliative or complete surgical repairs. It is with this knowledge in mind that MDCT provides exquisite detail of complex, 3-dimensional anatomic relations. This review illustrates the spectrum of MDCT findings in the adult with simple and complex forms of congenital heart disease.