1. Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography.
- Author
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Ciolina F, Sedati P, Zaccagna F, Galea N, Noce V, Miraldi F, Cavarretta E, Francone M, and Carbone I
- Subjects
- Aged, Aorta, Thoracic diagnostic imaging, Aortic Diseases diagnostic imaging, Aortic Valve physiopathology, Aortic Valve surgery, Aortic Valve Stenosis physiopathology, Aortic Valve Stenosis surgery, Aortography methods, Calcinosis physiopathology, Calcinosis surgery, Cardiac-Gated Imaging Techniques, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Electrocardiography, Feasibility Studies, Female, Humans, Hypertrophy, Left Ventricular diagnostic imaging, Male, Middle Aged, Predictive Value of Tests, Radiographic Image Interpretation, Computer-Assisted, Severity of Illness Index, Aortic Valve diagnostic imaging, Aortic Valve pathology, Aortic Valve Stenosis diagnostic imaging, Calcinosis diagnostic imaging, Coronary Angiography methods, Multidetector Computed Tomography
- Abstract
Aim: In patients affected by aortic valve stenosis (AS) it is mandatory to rule out coronary artery disease (CAD). The role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) was assessed in patients with AS referred for surgical valve replacement., Methods: Forty-two patients with AS underwent ECG-gated 64-SCTA of thoracic aorta, including the heart and coronary arteries, before surgical valve replacement. Images were evaluated by two independent readers and compared with surgical findings in terms of aortic valve calcification grading, valvular morphology, aortic valve annulus and sino-tubular junction diameters, and valvular area planimetry. Quantitative evaluation of cusps opening was also performed. Finally, the presence of CAD, thoracic aortic aneurysm and left ventricle hypertrophy were assessed., Results: Visualization of the aortic valve without motion artefacts was possible in 38 patients (90.5%). Valvular morphology was correctly assessed in all cases (100%). 64-SCTA correctly determined aortic valve calcification grading and the aortic valve annulus and sinotubular junction diameters in 100% of cases. The aortic valve planimetric area was assessed in 38 cases (90.5%). Ascending aortic aneurysms requiring surgical replacement were detected in 12 patients (28.6%). Significant left ventricle hypertrophy was found in 30 patients (71%)., Conclusion: Preoperative evaluation of patients undergoing surgical replacement for AS with 64-SCTA is feasible. 64-SCTA can rule out CAD and evaluate the status of the aortic valve and thoracic aorta in the same examination, obtaining relevant information for surgical planning.
- Published
- 2015