Non obstructive high-risk plaque but not calcified by coronary CTA, and the G-score predict ischemia.

Background: The association of plaque morphology with ischemia in non-obstructive lesions has not been fully eludicated: Calcium density and high-risk plaque features have not been explored.

Objectives: to assess whether high-risk plaque or calcified, and global mixed including non-calcified plaque burden (G-score) by coronary CTA predict ischemia in non-obstructive lesions using non-invasive fractional flow reserve (FFR).

Methods: In 106 patients with low-to-intermediate pre-test probability referred to coronary 128-slice dual source CTA, lesion-based and distal FFR were computated.

Robotically assisted hybrid coronary revascularization: does sequence of intervention matter?

Objective: Hybrid coronary revascularization (HCR) is a treatment strategy for the revascularization of multivessel coronary disease that combines the advantages of both minimally invasive surgical techniques and percutaneous coronary intervention (PCI). The optimal sequence by which revascularization should be accomplished has not been determined. We investigated clinical outcomes in a series of patients planned for HCR via robotically assisted totally endoscopic coronary artery bypass (TECAB) and standard PCI based on revascularization sequence.

Differences in coronary plaque composition by noninvasive computed tomography angiography in individuals with and without obstructive coronary artery disease.

Background: Coronary CT angiography (CCTA) has emerged as a promising non-invasive tool to detect coronary artery disease (CAD) which provides additional information about atherosclerotic plaque composition. We aimed to assess whether differences in plaque composition and plaque burden exist across patients with more and <50% coronary stenosis.

Methods: 1060 patients (58±11 years, 43% females) with an intermediate risk of CAD referred for 64-slice CCTA were studied.

Evaluation of left ventricular function by 64-multidetector computed tomography in patients undergoing totally endoscopic coronary artery bypass grafting.

Objectives: The goal of this study was to quantify left ventricular (LV) function with automated 3-dimensional volume segmentation by 64-slice computed tomography (CT) in patients undergoing totally endoscopic coronary artery bypass grafting (CABG).

Methods: We used 64-multidetector CT coronary angiography to examine 63 patients with >70% coronary stenosis who were undergoing totally endoscopic CABG for single-vessel disease (left internal mammary artery to left anterior descending coronary artery) or multivessel disease with the da Vinci robotic surgical device (arrested heart approach). CT measurements were compared with cineventriculography results in 20 patients.

Is there a relation between non-calcifying coronary plaques and acute coronary syndromes? A retrospective study using multislice computed tomography.

Objectives: The purpose of this study was to assess whether different coronary plaque types as classified by multislice computed tomography (CT) are retrospectively correlated with acute coronary syndromes (ACS) in an unselected study population.

Methods: Sixty-three consecutive patients were examined with 16-slice CT coronary angiography. Coronary plaque types were classified as calcifying type 1, mixed (calcifying > non-calcifying) type 2, mixed (non-calcifying > calcifying) type 3, and non-calcifying type 4.

Diagnostic performance of 64-slice computed tomography in evaluation of coronary artery bypass grafts.

Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of greater than 50% graft stenosis within 2 weeks of coronary artery bypass grafting and to investigate the clinical value of 64-slice CT.

Subjects And Methods: Forty-one patients (70 grafts, 46 arterial and 24 venous) underwent 64-slice CT a mean of 2.6 years after minimally invasive or conventional coronary artery bypass surgery.

Hybrid coronary artery revascularization--review and update 2007.

Hybrid coronary revascularization is a combination of minimally invasive coronary artery bypass grafting and percutaneous coronary intervention in patients with multivessel coronary artery disease. The concept is now 10 years old. Implementation was slow, but major developments have taken place.

Aortic valve calcification as quantified with multislice computed tomography predicts short-term clinical outcome in patients with asymptomatic aortic stenosis.

Background And Aim Of The Study: Aortic valve calcification may be an independent risk factor for adverse clinical outcome. The study aim was to assess the predictive value of possible risk factors, including the severity of aortic valve calcification as quantified with 16-multislice computed tomography (MSCT) for adverse short-term clinical outcome in patients with asymptomatic, degenerative aortic stenosis (AS).

Methods: Possible risk factors for adverse short-term clinical outcome were prospectively tested in 34 consecutive patients with asymptomatic AS as follows: (i) aortic valve calcium (AVC) score as quantified with MSCT; (ii) echocardiographic parameters--aortic valve area (AVA) calculated with continuity equation, mean and maximal transvalvular pressure gradients, end-diastolic septal wall diameter; and (iii) laboratory tests (brain natriuretic peptide (BNP), C-reactive protein (CRP)).

Evaluation of ascending aortic atherosclerosis with 16-multidetector computed tomography is useful before total endoscopic coronary bypass surgery.

Background: The purpose of this study was to investigate the assessment of ascending aortic atherosclerosis with 16-multidetector computed tomography (16-MDCT) angiography prior to total endoscopic coronary artery bypass (TECAB) surgery.

Methods: Forty-five patients were examined with electrocardiogram-gated, 16-MDCT angiography. The presence of atherosclerosis at the ascending aorta was graduated as severe (>50% of circumference) or as mild (<50% of circumference).

Diagnostic performance of MDCT for detecting aortic valve regurgitation.

Objective: This study evaluates whether ECG-gated 16-MDCT coronary angiography provides a reliable imaging technique for detecting aortic regurgitation (AR).

Subjects And Methods: We examined 71 patients prospectively with 16-MDCT angiography using retrospective ECG gating during the mid-to-end diastolic phase. A visible central valvular leakage area was considered as a diagnostic criterion for AR.

Multislice computed tomography for detection of patients with aortic valve stenosis and quantification of severity.

Objectives: The purpose of this study was to evaluate whether multislice computed tomography (MSCT) provides a reliable, noninvasive imaging modality for identification of patients with degenerative aortic valve stenosis (AS) by quantifying the aortic valve area (AVA) in comparison to the accepted diagnostic standard transthoracic echocardiography (TTE).

Background: Management of patients with degenerative AS is based on the severity of disease. The severity of AS in clinical practice is assessed by TTE and classified as mild, moderate, or severe according to the AVA.

Reduction of soluble P-selectin by statins is inversely correlated with the progression of coronary artery disease.

Background: Cell adhesion molecules (CAM) play an important role in the pathogenesis of atherosclerosis by mediating the binding of leukocytes to the endothelium. Soluble CAM isoforms are known to be elevated in the sera of patients suffering from coronary artery disease (CAD).

Methods: We measured the concentrations of soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, P-selectin, platelet endothelial cell adhesion molecule-1, and highly sensitive C-reactive protein (hs-CRP) in the blood of 47 CAD patients before and 6 months after starting statin therapy and in 16 untreated CAD patients.

High-resolution 16-MDCT evaluation of radial artery for potential use as coronary artery bypass graft: a feasibility study.

Objective: The objective of our study was to assess the feasibility of using 16-MDCT angiography for the preoperative assessment of the radial and ulnar arteries and the palmar arches in patients scheduled for radial artery harvesting for coronary artery bypass graft (CABG) surgery.

Conclusion: Sixteen-MDCT angiography shows promise for the noninvasive preoperative assessment of the radial artery as a CABG donor site.

Hybrid coronary artery revascularization: logistics and program development.

Planning hybrid coronary artery revascularization--a combination of cardiac surgery with percutaneous procedures--requires, at first sight, a very complex logistical setup. Technical and equipment related details should be defined as early as possible in order to have time for training of all OR personnel involved. The most challenging aspect in OR-located hybrid coronary revascularization remains a very close cooperation of cardiac surgeons and interventional cardiologists.