OBJECTIVE: Myocardial scintigraphy and/or conventional angiography (CA) are often performed before cardiac surgery in an attempt to identify unsuspected coronary artery disease which might result in significant cardiac morbidity and mortality. Multidetector CT coronary angiography (MDCTCA) has a recognised high negative predictive value and may provide a non-invasive alternative in this subset of patients. The aim of this study was to evaluate the clinical value of MDCTCA as a preoperative screening test in candidates for non-coronary cardiac surgery. METHODS: 132 patients underwent MDCTCA (Somatom Sensation 16 Cardiac, Siemens) in the assessment of the cardiac risk profile before surgery. Coronary arteries were screened for > or = 50% stenosis. Patients without significant stenosis (Group 1) underwent surgery without any adjunctive screening tests while all patients with coronary lesions > or = 50% at MDCTCA (Group 2) underwent CA. RESULTS: 16 patients (12.1%) were excluded due to poor image quality. 72 patients without significant coronary stenosis at MDCTCA were submitted to surgery. 30 out of 36 patients with significant (> or = 50%) coronary stenosis at MDCTCA and CA underwent adjunctive bypass surgery or coronary angioplasty. In 8 patients, MDCTCA overestimated the severity of the coronary lesions (> 50% MDCTCA, < 50% CA). No severe cardiovascular perioperative events such as myocardial ischaemia, myocardial infarction or cardiac failure occurred in any patient in Group 1. CONCLUSIONS: MDCTCA seems to be effective as a preoperative screening test prior to non-coronary cardiac surgery. In this era of cost containment and optimal care of patients, MDCTCA is able to provide coronary vessel and ventricular function evaluation and may become the method of choice for the assessment of a cardiovascular risk profile prior to major surgery.
OBJECTIVE: Myocardial scintigraphy and/or conventional angiography (CA) are often performed before cardiac surgery in an attempt to identify unsuspected coronary artery disease which might result in significant cardiac morbidity and mortality. Multidetector CT coronary angiography (MDCTCA) has a recognised high negative predictive value and may provide a non-invasive alternative in this subset of patients. The aim of this study was to evaluate the clinical value of MDCTCA as a preoperative screening test in candidates for non-coronary cardiac surgery. METHODS: 132 patients underwent MDCTCA (Somatom Sensation 16 Cardiac, Siemens) in the assessment of the cardiac risk profile before surgery. Coronary arteries were screened for > or = 50% stenosis. Patients without significant stenosis (Group 1) underwent surgery without any adjunctive screening tests while all patients with coronary lesions > or = 50% at MDCTCA (Group 2) underwent CA. RESULTS: 16 patients (12.1%) were excluded due to poor image quality. 72 patients without significant coronary stenosis at MDCTCA were submitted to surgery. 30 out of 36 patients with significant (> or = 50%) coronary stenosis at MDCTCA and CA underwent adjunctive bypass surgery or coronary angioplasty. In 8 patients, MDCTCA overestimated the severity of the coronary lesions (> 50% MDCTCA, < 50% CA). No severe cardiovascular perioperative events such as myocardial ischaemia, myocardial infarction or cardiac failure occurred in any patient in Group 1. CONCLUSIONS: MDCTCA seems to be effective as a preoperative screening test prior to non-coronary cardiac surgery. In this era of cost containment and optimal care of patients, MDCTCA is able to provide coronary vessel and ventricular function evaluation and may become the method of choice for the assessment of a cardiovascular risk profile prior to major surgery.
Authors: R A O'Rourke; B H Brundage; V F Froelicher; P Greenland; S M Grundy; R Hachamovitch; G M Pohost; L J Shaw; W S Weintraub; W L Winters; J S Forrester; P S Douglas; D P Faxon; J D Fisher; G Gregoratos; J S Hochman; A M Hutter; S Kaul; M J Wolk Journal: Circulation Date: 2000-07-04 Impact factor: 29.690
Authors: Kim A Eagle; Peter B Berger; Hugh Calkins; Bernard R Chaitman; Gordon A Ewy; Kirsten E Fleischmann; Lee A Fleisher; James B Froehlich; Richard J Gusberg; Jeffrey A Leppo; Thomas Ryan; Robert C Schlant; William L Winters; Raymond J Gibbons; Elliott M Antman; Joseph S Alpert; David P Faxon; Valentin Fuster; Gabriel Gregoratos; Alice K Jacobs; Loren F Hiratzka; Richard O Russell; Sidney C Smith Journal: Circulation Date: 2002-03-12 Impact factor: 29.690
Authors: S Achenbach; T Giesler; D Ropers; S Ulzheimer; H Derlien; C Schulte; E Wenkel; W Moshage; W Bautz; W G Daniel; W A Kalender; U Baum Journal: Circulation Date: 2001-05-29 Impact factor: 29.690
Authors: Kai Uwe Juergens; Matthias Grude; David Maintz; Eva Maria Fallenberg; Thomas Wichter; Walter Heindel; Roman Fischbach Journal: Radiology Date: 2003-12-10 Impact factor: 11.105
Authors: A F Kopp; S Schroeder; A Kuettner; A Baumbach; C Georg; R Kuzo; M Heuschmid; B Ohnesorge; K R Karsch; C D Claussen Journal: Eur Heart J Date: 2002-11 Impact factor: 29.983
Authors: Liesbeth P Salm; Joanne D Schuijf; Albert de Roos; Hildo J Lamb; Hubert W Vliegen; J Wouter Jukema; Raoul Joemai; Ernst E van der Wall; Jeroen J Bax Journal: Eur J Echocardiogr Date: 2005-08-10
Authors: G Landesberg; M Mosseri; D Zahger; Y Wolf; M Perouansky; H Anner; B Drenger; Y Hasin; Y Berlatzky; C Weissman Journal: J Am Coll Cardiol Date: 2001-06-01 Impact factor: 24.094
Authors: Koen Nieman; Filippo Cademartiri; Pedro A Lemos; Rolf Raaijmakers; Peter M T Pattynama; Pim J de Feyter Journal: Circulation Date: 2002-10-15 Impact factor: 29.690
Authors: V Buffa; C N De Cecco; L Cossu; S Fedeli; A Vallone; R Ruopoli; M Luzietti; G Angelica; V David; F Musumeci Journal: Radiol Med Date: 2010-03-09 Impact factor: 3.469
Authors: Martijn A M den Dekker; Kristof de Smet; Geertruida H de Bock; Rene A Tio; Matthijs Oudkerk; Rozemarijn Vliegenthart Journal: Eur Radiol Date: 2012-07-15 Impact factor: 5.315