title: Multidetector computed tomographic coronary angiography as an alternative to conventional coronary angiography in non-coronary surgical patients.
abstract: OBJECTIVE
  Aim of our study was to evaluate multidetector 64-slice spiral computed tomography (MSCT) as an alternative to traditional coronary angiography (CA) to detect concomitant coronary artery disease (CAD) in patients initially admitted for non-coronary surgical procedures.
  
  
  METHODS
  We have analyzed data of 380 consecutive patients operated from 2006 to 2008 initially admitted for aortic (N.=170) or mitral (N.=67) valve disease, ascending aorta aneurysm ± aortic valve disease (N.=99), and other (combined valve diseases, tumors; N.=44). These patients were submitted either to MSCT (Group CT, N.=112) or to CA (Group A, N.=268). Inclusion criteria to perform MSCT were no previous myocardial infarction or documented CAD, normal left ventricular function, sinus rhythm, less than 2-3 premature ventricular or atrial contractions /min.
  
  
  RESULTS
  In Group CT, CAD was definitively excluded in 95 patients (85%) and was detected in 17; 8 of those 17 patients were subsequently submitted to CA and coronary artery bypass surgery for significant CAD. As compared to those in Group A, patients in Group CT were younger (64±15 vs. 70±10 years, P<0.0001), had less hypertension (P=0.0001), chest pain (P<0.05), peripheral vascular disease (P<0.05). NYHA class, incidence of diabetes, smoking habit, family history of CAD were similar. The incidence of operative mortality, postoperative myocardial infarction was not significantly different in both Group CT (0%) and A (0.4%) (P=NS).
  
  
  CONCLUSIONS
  In selected cardiac surgical patients less invasive 64-slice MSCT can be with some limits an alternative to CA to rule out CAD, as confirmed by the absence of postoperative ischemic complications.
authors.affiliation: Department of Cardiac Surgery, Policlinico Tor Vergata, Tor Vergata University of Rome, Rome, Italy. pa.nardi4@libero.it
authors.forename: P
authors.initials: P
authors.lastname: Nardi
authors.forename: A
authors.initials: A
authors.lastname: Pellegrino
authors.forename: A
authors.initials: A
authors.lastname: Romagnoli
authors.forename: C
authors.initials: C
authors.lastname: Mve Mvondo
authors.forename: S
authors.initials: S
authors.lastname: De Propris
authors.forename: M
authors.initials: M
authors.lastname: Sperandio
authors.forename: F
authors.initials: F
authors.lastname: Versaci
authors.forename: G
authors.initials: G
authors.lastname: Simonetti
authors.forename: L
authors.initials: L
authors.lastname: Chiariello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D006348:Cardiac Surgical Procedures; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D036542:Tomography, Spiral Computed; D014656:Vascular Surgical Procedures