ROLE OF CARDIAC COMPUTED TOMOGRAPHY IN STRUCTURAL AND CONGENITAL HEART DISEASES

Abstract

Cardiac computed tomography (CT) is a non-invasive, three-dimensional imaging modality that uses X-ray beams to generate detailed cross-sectional images of the heart and associated vasculature. By acquiring data from multiple angles around a single axis of rotation, the technology reconstructs high-resolution two- and three-dimensional representations that clinicians can examine from any orientation. Over the past two decades, cardiac CT has evolved into a cornerstone diagnostic and planning tool for a broad spectrum of structural and congenital heart diseases (CHD). This paper examines the clinical applications of cardiac CT across several key interventional contexts, including transcatheter aortic valve implantation (TAVI), transcatheter mitral and tricuspid valve interventions, left atrial appendage occlusion (LAAO), atrial septal defect (ASD) closure, ventricular septal defect (VSD) repair, patent ductus arteriosus (PDA) management, patent foramen ovale (PFO) assessment, and paravalvular leak (PVL) closure. Additionally, advances in CT hardware and software—including dual-source CT, four-dimensional CT, and artificial intelligence-assisted analysis—are reviewed. The findings indicate that cardiac CT offers unparalleled spatial resolution, reproducible quantitative measurements, and critical pre-procedural data essential for optimising patient outcomes in both paediatric and adult populations.