Preoperative coronary risk assessment with dual-source CT in patients undergoing noncoronary cardiac surgery.
OBJECTIVE
The aim of our work was to assess the role of dual-source computed tomography (DSCT) in the preoperative evaluation of coronary artery disease in patients scheduled for noncoronary cardiac surgery.


METHODS
One hundred patients were prospectively evaluated. Patients negative for coronary disease at DSCT (n=81) underwent surgery without coronary angiography. Patients positive for significant lesions or with nondiagnostic image quality due to artefacts or severe calcifications underwent coronary angiography (n=19) and were excluded from the study. In patients who underwent surgery with only a DSCT diagnosis, we evaluated the frequency of major adverse cardiac events (MACEs) during the perioperative period and at 3 months follow-up.


RESULTS
No MACEs were recorded during the perioperative period; three noncardiac complications (one surgical revision for bleeding, one cardiac tamponade and one respiratory insufficiency) and one death related to severe respiratory insufficiency were observed. None of the 80 patients had MACEs during the 3-month follow-up period.


CONCLUSIONS
Coronary evaluation with DSCT is able to rule out the presence of coronary disease in patients scheduled for cardiac surgery, without the need for coronary angiography confirmation. Patients with significant stenosis or nondiagnostic image quality should be referred for coronary angiography.
Buffa
V
V
Dipartimento di Radiologia Cardiovascolare, Ospedale San Camillo-Forlanini, Roma, Italy.
De Cecco
C N
CN
Cossu
L
L
Fedeli
S
S
Vallone
A
A
Ruopoli
R
R
Luzietti
M
M
Angelica
G
G
David
V
V
Musumeci
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods