Diagnostic accuracy of MDCT coronary angiography in patients referred for heart valve surgery.
OBJECTIVE
The aim of our study was to evaluate the role of multidetector-row computed tomography (MDCT) in patients referred for heart valve surgery. We studied the diagnostic performance of CT coronary angiography (CTCA) compared with conventional coronary angiography (CCA) before valve surgery.


METHODS
During a 13-month period, 55 consecutive patients under evaluation for aortic (40/55) or mitral valve (15/55) disease before potential valve replacement underwent CTCA using a 64-detector-row scanner within 2 months of CCA for comparative purposes. All 17 major coronary artery segments were evaluated by one observer and compared with the reference standard. Patient-based, vessel-based and segment-based analyses of the data were performed.


RESULTS
Prevalence of significant coronary artery disease, defined as having at least one stenosis >/=50% per patient, was 36%. On a patient-based analysis, sensitivity, specificity and positive and negative predictive values were 100%, 91%, 83% and 100%, respectively.


CONCLUSIONS
The diagnostic accuracy of 64-row CTCA for ruling out the presence of significant coronary stenoses in patients undergoing valve surgery is excellent and allows CTCA to be used as a gatekeeper for invasive CCA in these patients. MDCT is a necessary preoperative examination that provides useful information for identifying potential operative complications of surgical procedures.
Stagnaro
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Università degli Studi di Genova, Genova, Italy. n-s@libero.it
Della Latta
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D
Chiappino
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D
D000368:Aged; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011857:Radiographic Image Interpretation, Computer-Assisted; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol