Cardiac CT: Beyond Coronary Arteries Angiography

Congress:

ECR 2020

Poster Number:

C-14933

Type:

Educational Exhibit

Keywords:

Performed at one institution, Not applicable, Education and training, Cardiac Assist Devices, Diagnostic procedure, CT-Angiography, Vascular, Cardiac, Arteries / Aorta

Authors:

D. PETITE¹, A. Weitz Morandini², I. RIVERA², V. MOÑIVAS², S. MINGO², V. Cuartero Revilla², M. P. Hernandez²; ¹Majadahonda, SPAIN/ES, ²Madrid/ES

DOI:

10.26044/ecr2020/C-14933

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-14933

Fig. 1: Coronary CT Angiography. Coronal oblique image with MIP reformation shows right...

Fig. 2: Volume-rendered CTA image shows apical view of he heart, with a normal left...

Fig. 3: Coronary CT angiography. Sagittal projection left pulmonary veins ( white...

Fig. 6: Aortoiliac region is represented in this vascular volume-rendered coronal...

Learning objectives

To determine the possibilities of Cardiac CT for multiple processes beyond coronary artery disease. - Indications: patients with cardiac valvular diseases, heart chamber studies orendocarditis, as well as secondary to findings in ECG ( echocardiographic ) studies. - Examination protocols: coronary CT angiography and dedicated variants -Imaging findings: Depiction of findings and posterior 2D and 3D reconstruction.

Background

The widespread use of Multidetector Computed Tomography (MDCT) for detection of the coronary arteries disease has allowed this technique to demonstrate its capabilities, as for spatial and temporal resolution. In the last fifteen years, the world of both Cardiology and Thoracic Imaging has witnessed great steps in the diagnosis of cardiac CT´s main indication, coronary artery disease. Our experience with a 64-MDCT showed progressive improvements in coronary CTA, not only in depicting vascular anatomy and disease ( Fig. 1 ), including 2D and 3D, reformatted...

Findings and procedure details

1.TAVI Procedure 1.1 Objective, to obtain: -An aortic calcium score -An optimal view from aortic valve/root and left ventricle outflow tract. -A complete description of the entire aorta and iliac vessels. -The best vascular approach ( femoral vs subclavian). 1.2 Protocol/CTA planning: a. An initial non-contrast prospective cardiac study to achieve aortic valve calcification b. A second ECG-gated retrospective CTA study encompassing the entire chest from supraclavicular regions ( modified from a conventional Coronary CTA protocol) c. A third non-ECG-gated helical study including abdominopelvic regions...

Conclusion

Cardiac CT can play nowadays an important role for clinicians, interventional cardiologists and cardiovascular surgeons. In the daily practice, multiplanar images and 3D projections can readily assess anatomic references in several heart processes, and as a guide for surgical-interventional planning purposes, in case of devices placement, and subsequent follow-up.

Personal information and conflict of interest

D. Petite; Majadahonda, SPAIN/ES - nothing to disclose I. Rivera; Madrid/ES - nothing to disclose V. Moñivas; Madrid/ES - nothing to disclose S. Mingo; Madrid/ES - nothing to disclose A. Weitz Morandini; Madrid/ES - nothing to disclose V. Cuartero Revilla; Madrid/ES - nothing to disclose M. P. Hernandez; Madrid/ES - nothing to disclose Correspondence: David Petite. email: [email protected] Cardiology Department. V. Moñivas - Cardiac Imaging S. Mingo - Cardiac Imaging

References

Cochet , Hubert et al. Left atrial appendage patency and device-related thrombus after percutaneous left atrial appendage occlusion: a computed tomography study. European Heart Journal - Cardiovascular Imaging (2018) 19, 1351–1361. Moss AJ, Dweck MR, Dreisbach JG, et al. Complementary role of cardiac CT in the assessment of aortic valve replacement dysfunction. Open Heart 2016;3 Marvin H. Eng et al. Computed Tomography for Left Atrial Appendage Occlusion Case Planning.Interventional Cardiology Clinics, Volume 7, Issue 3, 367 – 378. Kotaro Ouchi et al. Diagnosis of infective...