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Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery

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Abstract

Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, 62 ± 13 years) scheduled to undergo valve surgery underwent 40-slice MDCT before invasive quantitative coronary angiography (QCA). According to QCA, 15 patients had CAD (5 one-vessel, 6 two-vessel and 4 three-vessel disease). The remaining 67 patients had no CAD. On a per-vessel basis, MDCT correctly identified 27/29 (sensitivity 93%) vessels with and excluded 277/299 vessels (specificity 93%) without CAD. On a per-patient basis, MDCT correctly identified 14/15 patients with (sensitivity 93%) and 60/67 patients without CAD (specificity 90%). Positive and negative predictive values of MDCT were 67% and 98%. Performing invasive angiography only in patients with abnormal MDCT might have avoided QCA in 60/82 (73%). MDCT could be potentially useful in the preoperative evaluation of patients with valve disease. By selecting only those patients with coronary lesions to undergo invasive coronary angiography, it could avoid cardiac catheterization in a large number of patients without CAD.

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Abbreviations

CAD:

coronary artery disease

CI:

confidence interval

LAD:

left anterior descending coronary artery

LCX:

left circumflex coronary artery

LM:

left main coronary artery

MDCT:

multidetector row computed tomography

NYHA:

New York Heart Association Functional Class

QCA:

quantitative coronary angiography

RCA:

right coronary artery

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Author information

Authors and Affiliations

  1. Cardiology Division, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, 1200, Woluwe St. Lambert, Belgium

    Anne-Catherine Pouleur, Jean-Benoît le Polain de Waroux, Joëlle Kefer, Agnès Pasquet, Jean-Louis Vanoverschelde & Bernhard L. Gerber

  2. Radiology Division, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, 1200, Woluwe St. Lambert, Belgium

    Emmanuel Coche

Authors
  1. Anne-Catherine Pouleur
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  2. Jean-Benoît le Polain de Waroux
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  3. Joëlle Kefer
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  4. Agnès Pasquet
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  5. Emmanuel Coche
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  6. Jean-Louis Vanoverschelde
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  7. Bernhard L. Gerber
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Corresponding author

Correspondence to Bernhard L. Gerber.

Additional information

This work was supported by a grant of the Fondation Nationale de la Recherche Scientifique of the Belgian Government (FRSM 3.4557.02). Dr. Pouleur is supported by a personal grant of the Fondation Nationale de la Recherche Scientifique of the Belgian Government.

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Pouleur, AC., le Polain de Waroux, JB., Kefer, J. et al. Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery. Eur Radiol 17, 3199–3207 (2007). https://doi.org/10.1007/s00330-007-0676-0

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  • DOI: https://doi.org/10.1007/s00330-007-0676-0

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