Preoperative coronary risk assessment with dual-source CT in patients undergoing noncoronary cardiac surgery

Purpose The aim of our work was to assess the role of dual-source computed tomography (DSCT) in the preoperative evaluation of coronary artery disease in patients scheduled for noncoronary cardiac surgery. Materials and methods One hundred patients were prospectively evaluated. Patients negative for...

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Bibliographic Details
Published in:Radiologia medica 2010-10, Vol.115 (7), p.1028-1037
Main Authors: Buffa, V., De Cecco, C.N., Cossu, L., Fedeli, S., Vallone, A., Ruopoli, R., Luzietti, M., Angelica, G., David, V., Musumeci, F.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cardiac Radiology/Cardioradiologia
Cardiac Surgical Procedures
Coronary Angiography
Coronary Artery Disease - diagnostic imaging
Diagnostic Radiology
Female
Humans
Imaging
Interventional Radiology
Male
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Preoperative Care
Radiology
Risk Assessment
Tomography, X-Ray Computed - methods
Ultrasound
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Summary:Purpose The aim of our work was to assess the role of dual-source computed tomography (DSCT) in the preoperative evaluation of coronary artery disease in patients scheduled for noncoronary cardiac surgery. Materials and methods One hundred patients were prospectively evaluated. Patients negative for coronary disease at DSCT (n=81) underwent surgery without coronary angiography. Patients positive for significant lesions or with nondiagnostic image quality due to artefacts or severe calcifications underwent coronary angiography (n=19) and were excluded from the study. In patients who underwent surgery with only a DSCT diagnosis, we evaluated the frequency of major adverse cardiac events (MACEs) during the perioperative period and at 3 months follow-up. Results No MACEs were recorded during the perioperative period; three noncardiac complications (one surgical revision for bleeding, one cardiac tamponade and one respiratory insufficiency) and one death related to severe respiratory insufficiency were observed. None of the 80 patients had MACEs during the 3-month follow-up period. Conclusions Coronary evaluation with DSCT is able to rule out the presence of coronary disease in patients scheduled for cardiac surgery, without the need for coronary angiography confirmation. Patients with significant stenosis or nondiagnostic image quality should be referred for coronary angiography.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-010-0543-y