title: Evaluation of cardiac morphology, function, and perfusion at low radiation dose before mitral valve surgery.
abstract: A low-dose cardiac CT examination for preoperative assessment of coronary artery disease and mitral valve annulus dimensions in 79-year-old female with mitral valve regurgitation, consisting of a prospectively ECG-triggered high-pitch first-pass perfusion scan under adenosine stress and a sequential scan at rest enabled the diagnosis of occlusion of the right coronary artery and high-grade stenosis of the left circumflex artery, reversible perfusion defects of the inferoseptal and inferolateral walls and a persistent inferior wall perfusion defect associated with inferior wall thinning and akinesia. All findings were confirmed with catheter coronary angiography and cardiac magnetic resonance imaging. Because of the diagnosis of peri-infarct ischemia, the patient underwent aortocoronary bypass grafting in addition to mitral valve reconstruction. CT allowed for comprehensive preoperative assessment of cardiac morphology, function, and perfusion at a low cumulative radiation dose of 4.3 mSv.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland. robertpaul.goetti@usz.ch
authors.forename: Robert
authors.initials: R
authors.lastname: Goetti
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: André
authors.initials: A
authors.lastname: Plass
authors.forename: Gudrun
authors.initials: G
authors.lastname: Feuchtner
mesh_terms: D000241:Adenosine; D000368:Aged; D006348:Cardiac Surgical Procedures; D055424:Cardiac-Gated Imaging Techniques; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine