Comparison study between conventional coronary angiography and coronary computed tomography angiography (CCTA) in preoperative assessment of coronaries in patient undergoing valve replacement / Waleed Khaled Ali Salem ; Supervsied Ayman Fathy Tawfiq Kaddah , Mohamed Helmy Mohamed , Abdalla Amin Selim Elagha

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: Coronary CCTA is currently not routinely recommended for detecting coronary artery stenosis before cardiac valve surgery. However with recent improvements in computed tomography technology MSCT become a promising noninvasive technique for the detection of significant coronary artery lesions. Objective: Assess prospectively whether the coronary computed tomography angiography (CCTA) is a non-invasive alternative to invasive conventional coronary angiography (CA) doing preoperative coronary assessment before valvular surgery with the same accuracy. Patient and methods: We studied 50 consecutive patients whom were scheduled for valve replacement and doing preoperative coronary assessment before surgery by both methods ICA and CCTA. We analyzed accuracy and agreement for segmental, vessels and patients based analysis for detection of significant stenosis which was defined as a luminal diameter decrease {u2265}50%.ectasia, calcifications, and congenital coronary anomalies. Also, we compared both techniques regarding radiation dose, contrast volume and complications. Non evaluable segments were excluded from accuracy at all level of analysis. The patients who refused to give their written informed consent or whom Crcl <60 ml/kg/min, asthmatic, Patients with arrhythmias, history of a severe allergic reaction to contrast medium, high coronary calcification scores, pregnant, very large obese, with acute heart failure, patient with metallic objects were excluded from the study

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