Accuracy of Multislice Computed Tomography in the Preoperative Assessment of Coronary Disease in Patients With Aortic Valve Stenosis
| Autor: | Jacques Mansourati, Grégoire Le Gal, Jean-Jacques Blanc, Jean-Christophe Cornily, Cedric Joret, Pierre-Yves Pennec, Jacques Boschat, Martine Gilard |
|---|---|
| Přispěvatelé: | Service d'Hémodynamique, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Cardiologie (BREST - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_treatment Coronary Artery Disease 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging Coronary artery disease MESH: Aged 80 and over 0302 clinical medicine Aortic valve replacement Prospective Studies MESH: Coronary Artery Disease MESH: Aortic Valve Stenosis Aged 80 and over Heart Valve Prosthesis Implantation MESH: Aged MESH: Middle Aged Middle Aged MESH: Predictive Value of Tests 3. Good health medicine.anatomical_structure Aortic valve stenosis Circulatory system Cardiology Female Radiology MESH: Tomography X-Ray Computed Cardiology and Cardiovascular Medicine Artery MESH: Preoperative Care MESH: Heart Valve Prosthesis Implantation medicine.medical_specialty Revascularization 03 medical and health sciences Predictive Value of Tests Internal medicine Preoperative Care medicine Humans Multislice Aged MESH: Humans business.industry Aortic Valve Stenosis medicine.disease MESH: Prospective Studies MESH: Male Stenosis Tomography X-Ray Computed business MESH: Female [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | Journal of the American College of Cardiology Journal of the American College of Cardiology, Elsevier, 2006, 47 (10), pp.2020-4. ⟨10.1016/j.jacc.2005.11.085⟩ |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2005.11.085 |
| Popis: | International audience; OBJECTIVES: To evaluate multislice computed tomography (MSCT) as an alternative to coronary angiography, we prospectively studied its diagnostic accuracy for the detection of significant coronary artery lesions in patients with significant aortic valve stenosis undergoing valve surgery. BACKGROUND: In patients with aortic valve stenosis, coronary angiography is still recommended before surgery. Multislice computed tomography is a promising noninvasive technique for the detection of significant coronary artery lesions. METHODS: Fifty-five consecutive patients scheduled for coronary angiography in the preoperative assessment of aortic valve stenosis underwent 16-slice MSCT 24 h before coronary angiography. We analyzed coronary lesions, image quality, and arterial calcium score. RESULTS: The sensitivity of the MSCT-based strategy in detecting significant stenosis was 100%, and its specificity 80%. The positive and negative predictive values were respectively 55% and 100%. For calcium scores 1,000, MSCT enabled conventional coronary angiography to be avoided in only 6% of cases, either because significant stenosis was found with a possible indication of revascularization, or because the examination was not interpretable. CONCLUSIONS: The results of this initial experience in relatively few patients suggest that MSCT-based coronary angiography may serve as an alternative to invasive coronary angiography to rule out significant coronary artery disease in patients scheduled for elective aortic valve replacement. Larger studies are necessary to fully explore the potential of coronary MSCT to improve preoperative risk stratification. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|