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Usefulness of 40-slice MDCT to detect coronary disease in patients prior to cardiac valve surgery

Publication
CT Marketing Philips Healthcare

Pouleur A, Polain de Waroux J, Kefer J, Pasquet A, Coche E, Vanoverschelde J and Gerber B.

* Originally published in the December 2007 edition of European Radiology.

 

Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, 62 ± 13 years) scheduled to undergo valve surgery underwent 40-slice MDCT before invasive quantitative coronary angiography (QCA). According to QCA, 15 patients had CAD (5 one-vessel, 6 two-vessel and 4 three-vessel disease). The remaining 67 patients had no CAD. On a per-vessel basis, MDCT correctly identified 27/29 (sensitivity 93%) vessels with and excluded 277/299 vessels (specificity 93%) without CAD. On a per-patient basis, MDCT correctly identified 14/15 patients with (sensitivity 93%) and 60/67 patients without CAD (specificity 90%). Positive and negative predictive values of MDCT were 67% and 98%. Performing invasive angiography only in patients with abnormal MDCT might have avoided QCA in 60/82 (73%). MDCT could be potentially useful in the preoperative evaluation of patients with valve disease. By selecting only those patients with coronary lesions to undergo invasive coronary angiography, it could avoid cardiac catheterization in a large number of patients without CAD.
For more information about this publication, check out the PubMed listing for this article.


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Publication
Brilliance 40-channel
Cardiac, coronary angiography, coronary arteries, coronary artery disease, lesions, prospective, quantitative CT, Vascular
 

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