Diagnostic accuracy of MDCT coronary angiography in patients referred for heart valve surgery

• DOI: 10.1007/s11547-009-0403-9
• Publication Date: 2009-06-01T01:32:34Z
• Authors: N. Stagnaro; D. Della Latta; D. Chiappino
• Keywords: Male; Heart Valve Diseases; Contrast Media; Coronary Disease; Coronary Angiography; Sensitivity and Specificity; Iopamidol; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Risk Factors; Prevalence; Humans; Radiographic Image Interpretation, Computer-Assisted; Female; Tomography, X-Ray Computed; Aged

The aim of our study was to evaluate the role of multidetector-row computed tomography (MDCT) in patients referred for heart valve surgery. We studied the diagnostic performance of CT coronary angiography (CTCA) compared with conventional coronary angiography (CCA) before valve surgery.During a 13-month period, 55 consecutive patients under evaluation for aortic (40/55) or mitral valve (15/55) disease before potential valve replacement underwent CTCA using a 64-detector-row scanner within 2 months of CCA for comparative purposes. All 17 major coronary artery segments were evaluated by one observer and compared with the reference standard. Patient-based, vessel-based and segment-based analyses of the data were performed.Prevalence of significant coronary artery disease, defined as having at least one stenosis >/=50% per patient, was 36%. On a patient-based analysis, sensitivity, specificity and positive and negative predictive values were 100%, 91%, 83% and 100%, respectively.The diagnostic accuracy of 64-row CTCA for ruling out the presence of significant coronary stenoses in patients undergoing valve surgery is excellent and allows CTCA to be used as a gatekeeper for invasive CCA in these patients. MDCT is a necessary preoperative examination that provides useful information for identifying potential operative complications of surgical procedures.