Eight-row multidetector computed tomography coronary angiography evaluation of significant coronary artery disease in patients with severe aortic valve stenosis.

The International Journal of Cardiovascular Imaging
Miia HolmströmKirsi Lauerma

Abstract

The aim of this study was to evaluate whether 8-row multidetector computed tomography coronary angiography (MDCT-CA) could replace invasive conventional coronary angiography (CCA) in patients with acquired severe aortic valve stenosis (AS). Coronary artery disease (CAD) diagnosis should be obtained with a noninvasive method in patients with AS undergoing valvular replacement. We evaluated the diagnostic accuracy of MDCT-CA in detecting high-grade (> or =50%) stenoses in the main coronary arteries in patients with AS. Twenty-three patients with acquired severe AS underwent both CCA and MDCT-CA. We calculated the total and volumetric calcium scores and evaluated the image quality of each coronary segment as assessable or nonassessable for stenosis. The images of the arteries were evaluated for the occurrence of artifacts and the presence of high-grade stenoses (> or =50%) by visual estimation and comparison with that of CCA. Of the 322 segments screened 224 were assessable for stenosis. Heavy calcium load rendered 37 (38%) of the 98 coronary segments nonassessable. Compared to CCA, MDCT-CA had a sensitivity of 63%, a specificity of 96%, a positive predictive value of 52%, and a negative predictive value of 98% for > or =50% steno...Continue Reading

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Citations

Feb 13, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Ronen DurstBenjamin Drenger
Sep 16, 2009·Journal de radiologie·J-M PernèsC Caussin

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