Feasibility and Accuracy of Aortic Valve Calcium Quantification on CT Angiography in Aortic Stenosis.

This study sought to derive and validate a systematic method enabling AVC quantification using computed tomography angiography (CTA) in patients with AS. METHODS: 134 consecutive patients with AS who underwent both NCCT and CTA were included in the study and sub-divided into derivation (n=71) and validation cohorts (n=63). On NCCT, AVC was quantified using Agatston method utilizing the software developed for semi-automatic assessment of coronary calcium. On CTA, mean contrast attenuation of aorta (AortaHU) and standard deviation (SD) was measured in the region-of-interest at level of sinotubular junction. RESULTS: Using an adjusted calcium detection threshold of AortaHU+2SD, AVCCTA was calculated utilizing the same software without modifying other parameters. Correlation between AVCNCCT and AVCCTA in the derivation cohort was excellent (r=0.9679;p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research

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This study sought to derive and validate a systematic method enabling AVC quantification using computed tomography angiography (CTA) in patients with AS.Methods134 consecutive patients with AS who underwent both NCCT and CTA were included in the study and sub-divided into derivation (n=71) and validation cohorts (n=63). On NCCT, AVC was quantified using Agatston method utilizing the software developed for semi-automatic assessment of coronary calcium. On CTA, mean contrast attenuation of aorta (AortaHU) and standard deviation (SD) was measured in the region-of-interest at level of sinotubular junction.ResultsUsing an adjus...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
In conclusion, on the basis of a significance cut-off value of 50% diameter stenosis, CTCA provides acceptable diagnostic accuracy for the exclusion of coronary artery disease in patients referred for TAVI. Using the routinely performed preoperative computed tomography scans as a gatekeeper for coronary angiography could decrease additional coronary angiographies by 37% in this high-risk and fragile population. PMID: 30178209 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - Category: Cardiology Authors: Tags: Neth Heart J Source Type: research
A 74-year old lady presented to our outpatient clinic with dyspnoea on exertion and fatigue after surgical aortic valve replacement with a 21  mm Medtronic Hancock II prosthesis in 2013. Transthoracic echocardiography showed premature prosthesis degeneration with severe aortic stenosis (peak pressure gradient (PG) 79 mmHg, mean pressure gradient (MPG) 48 mmHg;Figure A) due to immobilization of 2 leaflets (former right coronary and non-coronary cusps, Supplementary materialSupplementary material online,VideoS1), so that a screening for transcatheter valve-in-valve implantation was initiated. An electroc...
Source: European Heart Journal - Category: Cardiology Source Type: research
CONCLUSION: Non-contrast CMR protocol for the measurement of aortic annulus area is feasible and accurate. 3D-CMR could provide an alternative for annular sizing pre-TAVR assessment in patients who cannot undergo contrast-enhanced CT studies. PMID: 28570260 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Authors: Truong VT, Choo J, McCoy L, Mussman A, Ambach S, Kereiakes D, Sarembock I, Mazur W Abstract OBJECTIVES: To investigate the feasibility and image quality of low-dose contrast computed tomography (CT) angiography with pulmonary artery (PA) protocol. BACKGROUND: Aortic stenosis is the most common valvular heart disease and transcatheter aortic valve replacement (TAVR) has evolved as an alternative method for surgical valve replacement in intermediate-risk and high-risk surgical patients. CT is essential for measurement of aortic annulus prior to TAVR. METHODS: Twenty patients underwent a low-dose cont...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
one E Abstract Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this pati...
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
This study aimed to evaluate the diagnostic accuracy of coronary computed tomography angiography (CTA) for detecting coronary artery stenoses in patients with valvular heart disease undergoing valve surgery. Background Coronary CTA is currently not routinely recommended for detecting coronary artery stenoses before cardiac valve surgery. However, recent improvements in computed tomography technology may enable the identification of the most appropriate candidates for coronary CTA before valve surgery. Methods A systematic review was performed of PubMed, EMBASE, and the Cochrane databases for all studies that used &g...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - Category: Radiology Authors: Tags: CME Source Type: research
Opinion statementTranscatheter aortic valve replacement (TAVR) has emerged as an effective treatment alternative in patients with severe aortic stenosis (AS) who are deemed surgically high-risk or ineligible for surgery. Pre-procedural imaging, in particular computed tomography (CT), plays an integral part in the planning and performance of TAVR and is crucial for a successful treatment. Novel technological advances in CT include high-pitch, low kV acquisitions, and iterative reconstruction resulting in high image quality at substantially reduced scan duration, contrast volume, and radiation exposure. Given the high spatia...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Transcatheter aortic valve replacement (TAVR) is performed frequently in patients with severe, symptomatic aortic stenosis who are at high risk or inoperable for open surgical aortic valve replacement. Computed tomography angiography (CTA) has become the gold standard imaging modality for pre-TAVR cardiac anatomic and vascular access assessment. Traditionally, cardiac CTA is most frequently used for assessment of coronary artery stenosis, and scanning protocols have generally been tailored for this purpose.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Research paper Source Type: research
Abstract Determination of the coplanar view is a critical component of transcatheter aortic valve replacement (TAVR). The safety and accuracy of a novel reduced angular range C-arm computed tomography (CACT) approach coupled with a fully automated 3D analysis tool package to predict the coplanar view in TAVR was evaluated. Fifty-seven patients with severe symptomatic aortic stenosis deemed prohibitive-risk for surgery and who underwent TAVR were enrolled. Patients were randomized 2:1 to CACT vs. angiography (control) in estimating the coplanar view. These approaches to determine the coplanar view were compared qua...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
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