Computed tomography angiography for the interventional cardiologist.
In recent years, coronary CT angiography (CCTA) has become a widely adopted technique, not only due to its high diagnostic accuracy, but also to the fact that CCTA provides a comprehensive evaluation of the total (obstructive and non-obstructive) coronary atherosclerotic burden. More recently, this technique has become mature, with a large body of evidence addressing its prognostic validation. In addition, CT angiography has moved from the field of 'imagers' and clinicians and entered the interventional cardiology arena, aiding in the planning of both coronary and structural heart interventions, being transcatheter aortic valve implantation one of its most successful examples. It is therefore of utmost importance that interventional cardiologists become familiar with image interpretation and up-to-date regarding several CTA features, taking advantage of this information in planning the procedure, ultimately leading to improvement in patient outcomes. On the other hand, the increasing use of CCTA as a gatekeeper for invasive coronary angiography is expected to lead to an increase in the ratio of interventional to diagnostic procedures and significant changes in the daily cath-lab routine. In a foreseeable future, cath-labs will probably offer an invasive procedure only to patients expected to undergo an intervention, perhaps becoming in this change true interventional-labs.
Hospital de Santa Cruz, CHLO, Lisbon, Portugal Hospital da Luz, Lisbon, Portugal CEDOC, Chronic Diseases Research Center, FCM-NOVA, Lisbon, Portugal.
Pedro
P
de Araújo Gonçalves
Thoraxcenter, Erasmus Medical Center, Room z120, 's Gravendijkwal 230, Rotterdam, CE 3015, The Netherlands Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil.
Carlos A M
CA
Campos
Thoraxcenter, Erasmus Medical Center, Room z120, 's Gravendijkwal 230, Rotterdam, CE 3015, The Netherlands.
Patrick W
PW
Serruys
Thoraxcenter, Erasmus Medical Center, Room z120, 's Gravendijkwal 230, Rotterdam, CE 3015, The Netherlands hect2701@gmail.com.
Hector M
HM
Garcia-Garcia
D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
CT angiography; Coronary artery disease; Structural heart interventions