title: Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography.
abstract: OBJECTIVE
  In patients affected by aortic valve stenosis (AS) it is mandatory to rule out coronary artery disease (CAD). The role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) was assessed in patients with AS referred for surgical valve replacement.
  
  
  METHODS
  Forty-two patients with AS underwent ECG-gated 64-SCTA of thoracic aorta, including the heart and coronary arteries, before surgical valve replacement. Images were evaluated by two independent readers and compared with surgical findings in terms of aortic valve calcification grading, valvular morphology, aortic valve annulus and sino-tubular junction diameters, and valvular area planimetry. Quantitative evaluation of cusps opening was also performed. Finally, the presence of CAD, thoracic aortic aneurysm and left ventricle hypertrophy were assessed.
  
  
  RESULTS
  Visualization of the aortic valve without motion artefacts was possible in 38 patients (90.5%). Valvular morphology was correctly assessed in all cases (100%). 64-SCTA correctly determined aortic valve calcification grading and the aortic valve annulus and sinotubular junction diameters in 100% of cases. The aortic valve planimetric area was assessed in 38 cases (90.5%). Ascending aortic aneurysms requiring surgical replacement were detected in 12 patients (28.6%). Significant left ventricle hypertrophy was found in 30 patients (71%).
  
  
  CONCLUSIONS
  Preoperative evaluation of patients undergoing surgical replacement for AS with 64-SCTA is feasible. 64-SCTA can rule out CAD and evaluate the status of the aortic valve and thoracic aorta in the same examination, obtaining relevant information for surgical planning.
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, University "La Sapienza" Policlinico Umberto I, Rome, Italy - federica.ciolina@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Ciolina
authors.forename: P
authors.initials: P
authors.lastname: Sedati
authors.forename: F
authors.initials: F
authors.lastname: Zaccagna
authors.forename: N
authors.initials: N
authors.lastname: Galea
authors.forename: V
authors.initials: V
authors.lastname: Noce
authors.forename: F
authors.initials: F
authors.lastname: Miraldi
authors.forename: E
authors.initials: E
authors.lastname: Cavarretta
authors.forename: M
authors.initials: M
authors.lastname: Francone
authors.forename: I
authors.initials: I
authors.lastname: Carbone
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D055424:Cardiac-Gated Imaging Techniques; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012720:Severity of Illness Index