Simultaneous sizing and preoperative risk stratification for thoracic endovascular aneurysm repair: Role of gated computed tomography
| Autor: | Bart E. Muhs, Hence J.M. Verhagen, Felix J.V. Schlösser, Hamid Mojibian, Frans L. Moll, Alan Dardik |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Diseases medicine.medical_treatment Aorta Thoracic Coronary Angiography Aortography Risk Assessment Endovascular aneurysm repair Coronary artery disease Blood Vessel Prosthesis Implantation Electrocardiography Aortic aneurysm Aneurysm Predictive Value of Tests medicine.artery Internal medicine medicine Humans Thoracic aorta Aged Retrospective Studies Aged 80 and over Aorta Ejection fraction Aortic Aneurysm Thoracic business.industry Patient Selection Heart Middle Aged medicine.disease Coronary arteries Radiology Information Systems medicine.anatomical_structure cardiovascular system Cardiology Feasibility Studies Female Surgery Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular Surgery. 48:561-570 |
| ISSN: | 0741-5214 |
| Popis: | Objectives: Risk factors are similar for the development of both thoracic aortic aneurysms (TAA) and other cardiovascular diseases. Coronary artery disease is highly prevalent in patients with TAA, with a reported prevalence of 30% to 70%. Knowledge of the underlying cardiac pathology can minimize perioperative risk and improve patient selection. This study investigated the feasibility of simultaneous assessment of thoracic aortic pathology and cardiac structures and function, including the coronary arteries, using electrocardiogram-gated 64-slice computed tomography (CT) angiography. Methods: ECG-gated 64-detector row CT examinations of 11 patients (8 men, 3 women; mean age, 67 ± 16; range, 41-83 years) with thoracic aortic pathology, including aneurysms and dissections, were reviewed. Images were assessed for coronary artery disease, calcifications, cardiac function, and valve characteristics. Simultaneous assessment and measurements of thoracic aortic pathology were performed with the same scan. Results: All images of the patients could be successfully assessed for calcium scores, coronary artery stenoses, coronary artery anomalies, interventricular septal wall thickness, myocardial scar, left ventricular ejection fraction, muscle mass, and aortic and mitral valve calcification, mobility, and valve anatomy. Diagnostic image quality was also achieved in all patients for the underlying thoracic aortic disease. Conclusion: This study introduces the feasibility of dynamic imaging of the thoracic aorta and cardiac structures and function, including the coronary arteries, with just one CT scan. The images could be successfully assessed for thoracic aorta pathology, cardiac disease, and extracardiac pathology. With further developments of CT scanners-and more detailed insight in the prognosis of patients based on ECG-gated CTA findings-this new technique may become the initial imaging modality for preoperative cardiac risk stratification in patients with TAAs or dissections. |
| Databáze: | OpenAIRE |
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