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Imaging in Adult Congenital Heart Disease

Gaydos, Stephanie S. MD*; Varga-Szemes, Akos MD, PhD; Judd, Rochelle N. NP; Suranyi, Pal MD, PhD*,‡; Gregg, David MD

doi: 10.1097/RTI.0000000000000282
Symposium Review Articles

There has been tremendous growth in the population of adults with congenital heart disease (CHD) over the last few decades because of advances in medical care. Whereas some cases are cured during childhood, most patients instead undergo palliation, which leaves them at risk for late complications. Lifelong clinical follow-up involving serial multimodality imaging is helpful to monitor and guide the treatment of late complications. Imaging of these individuals is challenging because of their unique anatomy and therefore requires careful consideration on a case-by-case basis. Knowledge of late complications associated with various diseases and surgical palliations provides a basis for selection and interpretation of an appropriate imaging study. This review highlights the most common conditions in adult CHD and the clinical questions that imaging hopes to answer, as well as the advantages and disadvantages of available imaging modalities. We illustrate clinical scenarios and the use of noninvasive imaging modalities including echocardiography, computed tomography, and magnetic resonance imaging, as well as applications in the following CHDs: tetralogy of Fallot, transposition of the great arteries, coarctation of the aorta, shunts, functional single ventricle, and coronary anomalies.

*Division of Pediatric Cardiology, Department of Pediatrics

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science

Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC

Akos Varga-Szemes is a consultant and/or receives research support from Guerbet and Siemens. The remaining authors declare no conflicts of interest.

Correspondence to: David Gregg, MD, 25 Courtenay Dr, Charleston, SC 29464 (e-mail:

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