Computed tomographic coronary angiography: experience at Baylor University Medical Center/Baylor Jack and Jane Hamilton Heart and Vascular Hospital.

Noninvasive cardiac computed tomographic imaging using multislice or electron beam technology has been shown to be highly specific and sensitive in diagnosing coronary heart disease. It is about a fifth of the cost of coronary angiography and is particularly well suited for evaluating patients with a low or low to moderate probability of having obstructive coronary atherosclerosis. In addition, it offers more information than calcium scoring: because of the intravenous contrast used, it temporarily increases the density of the lumen and allows differentiation of soft plaque from calcified plaque. The Baylor Hamilton Heart and Vascular Hospital now uses this modality to define coronary atherosclerosis in patients who would otherwise have needed invasive coronary angiography; several research protocols with the technique are also under way. Baylor has recently upgraded to the 64-slice scanner. It is expected that computed tomographic coronary angiography will replace a significant percentage of invasive cardiac catheterizations.