[An evaluation of the effectiveness of applying 16-slice computed tomography (CT) to coronary arteries in preoperative aortic valve replacement].
An evaluation of the effectiveness of applying 16-slice Computed Tomography (CT) to coronary arteries in preoperative aortic valve replacement.


OBJECTIVE
To evaluate the effectiveness of using 16-slice CT to diagnose a significant stenosis in coronary arteries in patients with severe aortic valve stenosis.


METHODS
50 patients were included in the study. After a medium contrast injection, CT images of the arteries were taken using 0.75 mm slices. We paired the images with an ECG. Segments smaller than 1.5 mm were discarded, and the results were compared to those from the coronary angiography.


RESULTS
A satisfactory visualization of the coronary network was obtained for 80% (40/50) of the patients. For these 40 patients, 23 of the 29 patients without coronary stenosis were correctly classified but 4 of the 11 patients with coronary lesions were not recognized. The sensitivity of the multi-slice CT in detecting a least one significant coronary stenosis is 63.6%, the specificity 79.3%, positive predictive value 53.8% and negative predictive value 85.2%.


CONCLUSIONS
the 16-slice CT is a relatively effective and minimally invasive tool to highlight before valve replacement significant coronary stenosis in arteries greater than 1.5 mm in diameter in patients with severe aortic valvular stenosis. CT technology is currently insufficient for diagnosis, but we hope that with advances in multi-slice CT engineering, its use will help patients avoid invasive coronary angiographies.
Bammert
A
A
Centre hémodynamique et vascu laire interventionnel, Clinique cardiolo gique et des maladies vasculaires, Ins titut du Thorax, CHU de Nantes, bd Jacques Monod, 44093 Saint-Herblain, Nantes 1. bammert@chu.nantes.fr
Fihri
O Fassi
OF
Bressollette
E
E
Crochet
D
D
D000368:Aged; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed / Q000379:methods*