Conventional coronary angiography is recommended for patients scheduled for valve surgery, but 64-slice CT may be a better option for ruling out coronary lesions, according to a study from Erasmus Medical Center in Rotterdam, Netherlands.
"The diagnostic accuracy of 64-slice (coronary CT angiography or CTA) for ruling out the presence of significant coronary lesions in patients undergoing valve surgery is excellent and allows (coronary CTA) implementation as a gatekeeper in these patients," said lead author Dr. Willem Meijboom during a presentation at the 2006 American College of Cardiology (ACC) meeting in Atlanta.
Meijboom and colleagues prospectively examined 38 patients scheduled for valve surgery. Of these, 22 had aortic valve pathology, 14 had mitralic valve pathology, and two had pulmonary insufficiency. Three were having repeat surgery to correct or complete prior valve surgery.
According to the results, the CT scans detected all patients with a significant lesion (29%). The sensitivity of coronary CTA in detecting significant stenoses was 94% for segments and 100% for both vessels and patients. The specificity was 99% for segments, 97% for vessels, and 96% for patients.
The positive predictive value of coronary CTA compared to conventional angiography in detecting significant stenoses was 70% for segments, 76% for vessels, and 92% for patients.
The negative predictive value of coronary CTA compared to conventional angiography in ruling out significant stenoses was 100% on the basis of per segment, vessel, and patient.
Meijboom's group concluded that the 64-slice CT scanner is an excellent diagnostic tool in this patient population. Its diagnostic accuracy for these patients in ruling out or detecting significant coronary lesions was previously unknown, he added.
By Crystal Phend
AuntMinnie.com contributing writer
June 8, 2006
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