ABSTRACT
The utilization of real-time three-dimensional (3D) echocardiography, cardiac magnetic resonance imaging (cMRI), and cardiac computed tomography (cCT) has expanded the realm of congenital interventions. This chapter aims to provide the cardiologist with a general overview of complex adult congenital heart disease (ACHD) and its management options in the cardiac catheterization laboratory. In ACHD patients, angiography and oxygen saturations are performed at various cardiac locations, and each structure is evaluated for anatomy, function, and connections. Pulmonary angiography is used to evaluate pulmonary valve regurgitation or branch pulmonary stenoses. When performing such angiograms, the levophase angiogram is useful to identify the pulmonary vein drainage and additional left-sided structures and function. The chapter discusses the meticulous hemodynamic assessment across the coarctation which is essential to elucidate the peak systolic gradient. In evaluation of function, the injection rate can be decreased to evaluate the systolic function over several heartbeats.
