8th March 2024

Investigations

Chest radiography, ECG and echocardiography are performed routinely for all patients undergoing paediatric cardiac surgery. 

Post correction, the ECG may reveal RBBB and evidence of RVH. A QRS duration of > 180 ms is a predictor of ventricular arrhythmias. 

The chest x-ray will show a ‘boot-shaped’ heart due to RVH causing an upturned apex. There may be prominent pulmonary vascular markings and presence of a right sided aortic arch.

Echocardiography is useful in identifying residual VSD and the presence of aortic regurgitation. CMR can help to evaluate the right ventricle, previously placed shunts and aortopulmonary collaterals; quantify pulmonary regurgitation and identify scar tissue as well as associated cardiac defects (as mentioned above). 

Invasive cardiac catheterisation can assess levels of RVOT obstruction, pulmonary hypertension and residual shunts in addition to coronary artery anatomy.