scholarly journals Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial

2018 ◽  
Vol 28 (10) ◽  
pp. 4077-4085 ◽  
Author(s):  
Andreas Fuchs ◽  
J. Tobias Kühl ◽  
Marcus Y. Chen ◽  
David Viladés Medel ◽  
Xavier Alomar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Significant Coronary Artery Disease ◽  
Multicenter Trial ◽  
Artery Disease

scholarly journals Combined Coronary CT-Angiography and TAVI-Planning: A Contrast-Neutral Routine Approach for Ruling-Out Significant Coronary Artery Disease

2020 ◽  
Vol 9 (6) ◽  
pp. 1623
Author(s):  
Robin F. Gohmann ◽  
Philipp Lauten ◽  
Patrick Seitz ◽  
Christian Krieghoff ◽  
Christian Lücke ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Contrast Medium ◽  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Significant Coronary Artery Disease ◽  
Coronary Ct ◽  
Clinical Events ◽  
Group A ◽  
Artery Disease

Background: Significant coronary artery disease (CAD) is a common finding in patients undergoing transcatheter aortic valve implantation (TAVI). Assessment of CAD prior to TAVI is recommended by current guidelines and is mainly performed via invasive coronary angiography (ICA). In this study we analyzed the ability of coronary CT-angiography (cCTA) to rule out significant CAD (stenosis ≥ 50%) during routine pre-TAVI evaluation in patients with high pre-test probability for CAD. Methods: In total, 460 consecutive patients undergoing pre-TAVI CT (mean age 79.6 ± 7.4 years) were included. All patients were examined with a retrospectively ECG-gated CT-scan of the heart, followed by a high-pitch-scan of the vascular access route utilizing a single intravenous bolus of 70 mL iodinated contrast medium. Images were evaluated for image quality, calcifications, and significant CAD; CT-examinations in which CAD could not be ruled out were defined as positive (CAD+). Routinely, patients received ICA (388/460; 84.3%; Group A), which was omitted if renal function was impaired and CAD was ruled out on cCTA (Group B). Following TAVI, clinical events were documented during the hospital stay. Results: cCTA was negative for CAD in 40.2% (188/460). Sensitivity, specificity, PPV, and NPV in Group A were 97.8%, 45.2%, 49.6%, and 97.4%, respectively. Median coronary artery calcium score (CAC) was higher in CAD+-patients but did not have predictive value for correct classification of patients with cCTA. There were no significant differences in clinical events between Group A and B. Conclusion: cCTA can be incorporated into pre-TAVI CT-evaluation with no need for additional contrast medium. cCTA may exclude significant CAD in a relatively high percentage of these high-risk patients. Thereby, cCTA may have the potential to reduce the need for ICA and total amount of contrast medium applied, possibly making pre-procedural evaluation for TAVI safer and faster.

scholarly journals Combined Coronary CT-Angiography and TAVR Planning for Ruling Out Significant Coronary Artery Disease

2021 ◽  
Author(s):  
Robin F. Gohmann ◽  
Konrad Pawelka ◽  
Patrick Seitz ◽  
Nicolas Majunke ◽  
Linda Heiser ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Significant Coronary Artery Disease ◽  
Coronary Ct ◽  
Artery Disease
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