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Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery.

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Pouleur, Anne-Catherine [UCL] Le Polain De Waroux, Jean-Benoît [UCL] Kefer, Joëlle [UCL] Pasquet, Agnes [UCL] Coche, Emmanuel [UCL] Vanoverschelde, Jean-Louis [UCL] Gerber, Bernhard [UCL]

Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, 62 +/- 13 years) scheduled to undergo valve surgery underwent 40-slice MDCT before invasive quantitative coronary angiography (QCA). According to QCA, 15 patients had CAD (5 one-vessel, 6 two-vessel and 4 three-vessel disease). The remaining 67 patients had no CAD. On a per-vessel basis, MDCT correctly identified 27/29 (sensitivity 93%) vessels with and excluded 277/299 vessels (specificity 93%) without CAD. On a per-patient basis, MDCT correctly identified 14/15 patients with (sensitivity 93%) and 60/67 patients without CAD (specificity 90%). Positive and negative predictive values of MDCT were 67% and 98%. Performing invasive angiography only in patients with abnormal MDCT might have avoided QCA in 60/82 (73%). MDCT could be potentially useful in the preoperative evaluation of patients with valve disease. By selecting only those patients with coronary lesions to undergo invasive coronary angiography, it could avoid cardiac catheterization in a large number of patients without CAD.

Document type Article de périodique (Journal article) – Journal Article, Research Support, Non-U.S. Gov't
Access type Accès restreint
Publication date 2007
Journal information "European radiology" - Vol. 17, no. 12, p. 3199-3207 (2007)
Peer reviewed yes
issn 0938-7994
Publication status Publié
Affiliations UCL - MD/MINT - Département de médecine interne
UCL - MD/RAIM - Département de radiologie et d'imagerie médicale
UCL - (SLuc) Service de cardiologie
UCL - (SLuc) Service de radiologie
MESH Subject Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Disease - radiography - surgery ; Female ; Heart Valve Diseases - radiography - surgery ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods
Links
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Bibliographic reference Pouleur, Anne-Catherine ; Le Polain De Waroux, Jean-Benoît ; Kefer, Joëlle ; Pasquet, Agnes ; Coche, Emmanuel ; et. al. Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery.. In: European radiology, Vol. 17, no. 12, p. 3199-3207 (2007)
Permanent URL http://hdl.handle.net/2078.1/26664