Accuracy of multislice computed tomography in the preoperative assessment of coronary disease in patients with aortic valve stenosis. - Université de Bretagne Occidentale Access content directly
Journal Articles Journal of the American College of Cardiology Year : 2006

Accuracy of multislice computed tomography in the preoperative assessment of coronary disease in patients with aortic valve stenosis.

Abstract

OBJECTIVES: To evaluate multislice computed tomography (MSCT) as an alternative to coronary angiography, we prospectively studied its diagnostic accuracy for the detection of significant coronary artery lesions in patients with significant aortic valve stenosis undergoing valve surgery. BACKGROUND: In patients with aortic valve stenosis, coronary angiography is still recommended before surgery. Multislice computed tomography is a promising noninvasive technique for the detection of significant coronary artery lesions. METHODS: Fifty-five consecutive patients scheduled for coronary angiography in the preoperative assessment of aortic valve stenosis underwent 16-slice MSCT 24 h before coronary angiography. We analyzed coronary lesions, image quality, and arterial calcium score. RESULTS: The sensitivity of the MSCT-based strategy in detecting significant stenosis was 100%, and its specificity 80%. The positive and negative predictive values were respectively 55% and 100%. For calcium scores <1,000 (77% of patients), MSCT detected all patients without coronary artery disease, enabling conventional coronary angiography to be avoided in 35 of 55 cases (80%). For calcium scores >1,000, MSCT enabled conventional coronary angiography to be avoided in only 6% of cases, either because significant stenosis was found with a possible indication of revascularization, or because the examination was not interpretable. CONCLUSIONS: The results of this initial experience in relatively few patients suggest that MSCT-based coronary angiography may serve as an alternative to invasive coronary angiography to rule out significant coronary artery disease in patients scheduled for elective aortic valve replacement. Larger studies are necessary to fully explore the potential of coronary MSCT to improve preoperative risk stratification.

Dates and versions

hal-00689493 , version 1 (19-04-2012)

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Martine Gilard, Jean-Christophe Cornily, Pierre-Yves Pennec, Cedric Joret, Grégoire Le Gal, et al.. Accuracy of multislice computed tomography in the preoperative assessment of coronary disease in patients with aortic valve stenosis.. Journal of the American College of Cardiology, 2006, 47 (10), pp.2020-4. ⟨10.1016/j.jacc.2005.11.085⟩. ⟨hal-00689493⟩
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