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Approximately 50% of patients with severe aortic stenosis (AS) are asymptomatic. Whether a strategy of early aortic valve replacement (AVR) compared to a conservative “watchful waiting” approach is preferred in these patients is uncertain and controversial. We performed a study-level meta

Aortic dissection (AoD) is a rare complication of pregnancy. Women with connective tissue disorders (CTD) are at increased risk. Our aim was to detail the clinical features, underlying disorders and outcomes of women with acute AoD related to pregnancy in the IRAD database. 15/3712 of AoD in IRAD

The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria ( 1 ). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research.