The role of computed tomography in pre-procedural planning of cardiovascular surgery and intervention

Rajiah, Prabhakar; Schoenhagen, Paul

doi:10.1007/s13244-013-0270-8

Cited by 43 publications

(14 citation statements)

References 60 publications

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“…Iterative reconstruction has been evaluated in several domains, most notably in coronary CTA [ 18 – 20 ], as well as for other organ scanning such as lung and in re-operative cardiac surgery [ 21 – 23 ]. There have been several recent publications evaluating iterative reconstruction for CAC both in anthropomorphic phantoms and in patients at standard radiation doses with varying success (Table 1 ).…”

Section: Use Of Iterative Reconstructionmentioning

confidence: 99%

Low Radiation Dose Calcium Scoring: Evidence and Techniques

Baron

Choi

Chen

2016

Curr Cardiovasc Imaging Rep

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Coronary computed tomography (CT) allows for the acquisition of thin slices of the heart and coronary arteries, which can be used to detect and quantify coronary artery calcium (CAC), a marker of atherosclerotic cardiovascular disease. Despite the proven clinical value in cardiac risk prognostication, there remain concerns regarding radiation exposure from CAC CT scans. There have been several recent technical advancements that allow for significant radiation dose reduction in CAC scoring. This paper reviews the clinical utility and recent literature in low radiation dose CAC scoring.

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Section: Use Of Iterative Reconstructionmentioning

confidence: 99%

Low Radiation Dose Calcium Scoring: Evidence and Techniques

Baron

Choi

Chen

2016

Curr Cardiovasc Imaging Rep

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“…TAVI is however still associated with a number of adverse effects, such as paravalvular leakage, stroke, coronary obstruction, and conduction disorders [ 10 ]. CT Angiography (CTA) imaging plays an important role in pre-operative surgical planning and patient selection and can be used for post-operative outcome assessment [ 11 ]. Preprocedural assessment of patient eligibility and sizing parameters of the aortic root are both crucial to choose the suitable type of prosthesis as well as the prosthesis dimensions [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Automatic aortic root landmark detection in CTA images for preprocedural planning of transcatheter aortic valve implantation

Elattar

Wiegerinck

Kesteren

et al. 2015

Int J Cardiovasc Imaging

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Transcatheter aortic valve implantation is currently a well-established minimal invasive treatment option for patients with severe aortic valve stenosis. CT Angiography is used for the pre-operative planning and sizing of the prosthesis. To reduce the inconsistency in sizing due to interobserver variability, we introduce and evaluate an automatic aortic root landmarks detection method to determine the sizing parameters. The proposed algorithm detects the sinotubular junction, two coronary ostia, and three valvular hinge points on a segmented aortic root surface. Using these aortic root landmarks, the automated method determines annulus radius, annulus orientation, and distance from annulus plane to right and left coronary ostia. Validation is performed by the comparison with manual measurements of two observers for 40 CTA image datasets. Detection of landmarks showed high accuracy where the mean distance between the automatically detected and reference landmarks was 2.81 ± 2.08 mm, comparable to the interobserver variation of 2.67 ± 2.52 mm. The mean annulus to coronary ostium distance was 16.9 ± 3.3 and 17.1 ± 3.3 mm for the automated and the reference manual measurements, respectively, with a mean paired difference of 1.89 ± 1.71 mm and interobserver mean paired difference of 1.38 ± 1.52 mm. Automated detection of aortic root landmarks enables automated sizing with good agreement with manual measurements, which suggests applicability of the presented method in current clinical practice.

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“…CT of the thorax has been shown to aid routine preoperative planning for redo cardiac surgery in evaluating retrosternal anatomic relations, 6 and more recently in minimally invasive or catheter based cardiac procedures. 7 There are no guidelines to suggest its use in routine conventional cardiac surgical procedures done via sternotomy. In the authors' institution, the need for CT thorax as part of preoperative planning is left to the discretion of the performing surgeon.…”

Section: Discussionmentioning

confidence: 99%

Routine Preoperative Screening Computed Tomography of the Thorax for Cardiac Surgery

Sule

et al. 2021

Preprint

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Purpose: This study aims to evaluate the role of screening computed tomography (CT) thorax in cardiac surgery by analysing presence of CT aortic calcifications in association with change of operative strategy and postoperative stroke, as well as CT features of emphysema with development of pneumonia.Methods: All patients who underwent cardiac surgery from January 2013 to October 2017 by a single surgeon were retrospectively studied. Patients who underwent screening CT thorax prior to cardiac surgery (CT group) were compared with those who did not (no CT group). Multivariate subgroup analyses were performed to determine significant association with postoperative outcomes.Results: 392 patients were included, of which 156 patients underwent preoperative screening CT thorax. Patients in the CT group were older (63.9 vs 59.0 years, p=0.001), had fewer recent myocardial infarction preoperatively (41 vs 56.4%, p=0.003) and better ejection fraction >30% (p=0.02). Operative strategy was changed in 4.3% of patients, and 4.9% suffered stroke postoperatively. Presence of CT aortic calcifications was significantly associated with change in operative strategy (OR 1.54, p=0.016) but not associated with postoperative stroke (OR 0.53, p=0.33). Age was an independent risk factor for change in operative strategy among patients with CT thorax (p=0.02). Multivariate age-adjusted analysis showed only palpable plaque to be significantly associated with change in operative strategy (p<0.001). None of the patients with CT emphysema features developed pneumonia.Conclusion: The results do not support routine use of preoperative screening CT thorax. It should only be recommended in older patients.

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The role of computed tomography in pre-procedural planning of cardiovascular surgery and intervention

Cited by 43 publications

References 60 publications

Low Radiation Dose Calcium Scoring: Evidence and Techniques

Low Radiation Dose Calcium Scoring: Evidence and Techniques

Automatic aortic root landmark detection in CTA images for preprocedural planning of transcatheter aortic valve implantation

Routine Preoperative Screening Computed Tomography of the Thorax for Cardiac Surgery

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