Multidetector computed tomography (MDCT) in coronary surgery: first experiences with a new tool for diagnosis of coronary artery disease
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Multidetector computed tomography (MDCT) in coronary surgery: first experiences with a new tool for diagnosis of coronary artery disease. / Treede, Hendrik; Becker, Christoph; Reichenspurner, Hermann; Knez, Andreas; Detter, Christian; Reiser, Maximilian; Reichart, Bruno.
in: ANN THORAC SURG, Jahrgang 74, Nr. 4, 10.2002, S. 1398-1402.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Multidetector computed tomography (MDCT) in coronary surgery: first experiences with a new tool for diagnosis of coronary artery disease
AU - Treede, Hendrik
AU - Becker, Christoph
AU - Reichenspurner, Hermann
AU - Knez, Andreas
AU - Detter, Christian
AU - Reiser, Maximilian
AU - Reichart, Bruno
PY - 2002/10
Y1 - 2002/10
N2 - BACKGROUND: Selective coronary angiography (SCA) is the standard invasive procedure for diagnosis in patients eligible for coronary artery bypass grafting (CABG). A recently developed, highly sensitive multidetector computed tomography (MDCT) scan holds promise to be of almost comparable quality and predictiveness. We examined a blinded series of preoperative patients who were admitted to hospital for conventional and minimally invasive CABG procedures. Patients underwent CT scans in addition to SCA; findings were compared regarding location and degree of coronary artery stenosis.METHODS: Twenty patients underwent electrocardiogram-gated helical CT scanning. Images with 250 ms effective exposure time were reconstructed with retrospective electrocardiogram gating. Location and degree of coronary stenoses were described and compared with findings of SCA. The study was limited to patients with a heart rate of less than 70 beats per minute and who had the ability to hold their breath for 20 to 30 seconds.RESULTS: Coronary arteries were clearly displayed by MDCT. Compared with SCA, sensitivity was 92%, specificity 84%, and negative predicted value 89% for significant stenosis (more than 50%). Early forms of atherosclerotic changes were even clearer on MDCT. In addition, the CT examination allowed differentiation of calcified and fatty or fibrous stenoses.CONCLUSIONS: Multidetector CT scanning is an effective noninvasive technique for the diagnosis of coronary artery disease. In selected patients, MDCT scanning might be able to replace SCA as a preoperative test for CABG procedures. The intrathoracic situs can be clearly exposed as it is important for the planning of minimally invasive CABG procedures.
AB - BACKGROUND: Selective coronary angiography (SCA) is the standard invasive procedure for diagnosis in patients eligible for coronary artery bypass grafting (CABG). A recently developed, highly sensitive multidetector computed tomography (MDCT) scan holds promise to be of almost comparable quality and predictiveness. We examined a blinded series of preoperative patients who were admitted to hospital for conventional and minimally invasive CABG procedures. Patients underwent CT scans in addition to SCA; findings were compared regarding location and degree of coronary artery stenosis.METHODS: Twenty patients underwent electrocardiogram-gated helical CT scanning. Images with 250 ms effective exposure time were reconstructed with retrospective electrocardiogram gating. Location and degree of coronary stenoses were described and compared with findings of SCA. The study was limited to patients with a heart rate of less than 70 beats per minute and who had the ability to hold their breath for 20 to 30 seconds.RESULTS: Coronary arteries were clearly displayed by MDCT. Compared with SCA, sensitivity was 92%, specificity 84%, and negative predicted value 89% for significant stenosis (more than 50%). Early forms of atherosclerotic changes were even clearer on MDCT. In addition, the CT examination allowed differentiation of calcified and fatty or fibrous stenoses.CONCLUSIONS: Multidetector CT scanning is an effective noninvasive technique for the diagnosis of coronary artery disease. In selected patients, MDCT scanning might be able to replace SCA as a preoperative test for CABG procedures. The intrathoracic situs can be clearly exposed as it is important for the planning of minimally invasive CABG procedures.
KW - Coronary Angiography/methods
KW - Coronary Artery Bypass
KW - Coronary Disease/diagnostic imaging
KW - Female
KW - Humans
KW - Male
KW - Sensitivity and Specificity
KW - Tomography, X-Ray Computed/methods
U2 - 10.1016/s0003-4975(02)04010-9
DO - 10.1016/s0003-4975(02)04010-9
M3 - SCORING: Journal article
C2 - 12400825
VL - 74
SP - 1398
EP - 1402
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 4
ER -