Transcatheter Aortic Valve Implantation Using the Evolut FX+ Platform With Optimal Diamond-Coronary Alignment.

We present one of the inaugural transcatheter aortic valve implantation procedures using the latest Medtronic platform, Evolut FX+. Successful coronary angiography was achieved within 28 seconds and 1 minute 49 seconds for the left and right coronary arteries, respectively. Postoperative cardiac computed tomography scan demonstrated optimal commissural and diamond-coronary alignment.

Intraindividual Comparison of Dose Reduction and Coronary Calcium Scoring Accuracy Using Kilovolt-independent and Tin Filtration CT Protocols.

Purpose To investigate the ability of kilovolt-independent (hereafter, kV-independent) and tin filter spectral shaping to accurately quantify the coronary artery calcium score (CACS) and radiation dose reductions compared with the standard 120-kV CT protocol. Materials and Methods This prospective, blinded reader study included 201 participants (mean age, 60 years ± 9.8 [SD]; 119 female, 82 male) who underwent standard 120-kV CT and additional kV-independent and tin filter research CT scans from October 2020 to July 2021.

Education level and the use of coronary computed tomography, functional testing, coronary angiography, revascularization, and outcomes-a 10-year Danish, nationwide, registry-based follow-up study.

Background And Aims: Coronary computed tomography angiography (CCTA) can guide downstream preventive treatment and improve patient prognosis, but its use in relation to education level remains unexplored.

Methods: This nationwide register-based cohort study assessed all residents in Denmark between 2008 and 2018 without coronary artery disease (CAD) and 50-80 years of age (n = 1 469 724). Residents were divided according to four levels of education: low, lower-mid, higher-mid, and high.

AI-based, automated chamber volumetry from gated, non-contrast CT.

Background: Accurate chamber volumetry from gated, non-contrast cardiac CT (NCCT) scans can be useful for potential screening of heart failure.

Objectives: To validate a new, fully automated, AI-based method for cardiac volume and myocardial mass quantification from NCCT scans compared to contrasted CT Angiography (CCTA).

Methods: Of a retrospectively collected cohort of 1051 consecutive patients, 420 patients had both NCCT and CCTA scans at mid-diastolic phase, excluding patients with cardiac devices.

Imaging for implementation of heart failure guidelines.

The classification of heart failure with implications for pharmacological therapeutic interventions rests on defining ejection fraction (EF) which is an imaging parameter. Imaging can provide diagnostic clues as to aetiology of heart failure; it can also guide and help assess response to treatment. Echocardiography, CMR, cardiac computed tomography, positron emission tomography, and Tc 99 m pyrophosphate scanning provide information about the aetiology of heart failure.

Role of Multimodality Imaging in Transcatheter Structural Interventions.

Cardiac imaging is the backbone for safe and optimal transcatheter structural interventions. Transthoracic echocardiogram is the initial modality to assess valvular disorders, while transesophageal echocardiogram is best to delineate the mechanism of valvular regurgitation, preprocedural assessment for transcatheter edge-to-edge repair, and for intraprocedural guidance. Cardiac computed tomography is the modality of choice for assessing calcifications, maneuvering multiplaner reconstruction of different cardiac structures, preprocedural planning for various transcatheter valve replacement, and assessing for hypoattenuated leaflet thickening and reduced leaflet motion.

Dynamic Imaging of Aortic Pathologies: Review of Clinical Applications and Imaging Protocols.

The past decade has seen significant advances in dynamic imaging of the aorta. Today's vascular surgeons have the opportunity to choose from a wide array of imaging modalities to evaluate different aortic pathologies. While vascular ultrasound and aortography are considered to be the bread and butter imaging modalities, newer dynamic imaging techniques provide time-resolved information in various aortic pathologies.

Outflow cannula alignment in continuous flow left ventricular devices is associated with stroke.

We sought to evaluate whether differences in left ventricular assist device (LVAD) canula alignment are associated with stroke. There is a paucity of clinical data on contribution of LVAD canulae alignment to strokes. We conducted a retrospective analysis of patients who underwent LVAD implantation at Houston Methodist hospital from 2011 to 2016 and included those who had undergone cardiac computed tomography (CT) with contrast.

Late Transcatheter Aortic Valve Thrombosis Leading to Cardiogenic Shock.

A 67-year-old woman with prior transcatheter aortic valve replacement presented with worsening dyspnea. Imaging revealed transcatheter aortic valve thrombosis and aortic stenosis. Despite oral anticoagulation, she progressively deteriorated and developed cardiogenic shock.

Sex differences in machine learning computed tomography-derived fractional flow reserve.

Coronary computed tomography angiography (CCTA) derived machine learning fractional flow reserve (ML-FFR) can assess the hemodynamic significance of coronary artery stenoses. We aimed to assess sex differences in the association of ML-FFR and incident cardiovascular outcomes. We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and single photon emission computed tomography (SPECT).

Dynamic Computed Tomography Angiography is More Accurate in Diagnosing Endoleaks than Standard Triphasic Computed Tomography Angiography and Enables Targeted Embolization.

Background: The primary objective was to compare the accuracy of dynamic computed tomography (CT) angiography (d-CTA) with standardized triphasic contrast enhanced CT angiography (t-CTA) in diagnosing endoleak type after endovascular aortic repair (EVAR) using digital subtraction angiography (DSA) as reference standard. The secondary objective was to study the impact of d-CTA on image fusion-guided endoleak embolization.

Methods: A retrospective review of patients who underwent d-CTA imaging after EVAR between March 2019 and July 2021 was performed.

Prosthetic Aortic Valve Thrombosis.

Prosthetic valve thrombosis is the second leading cause of prosthetic valve deterioration and is being more readily diagnosed with the use of echocardiography and multidetector cardiac CT. Presentation of valve thrombosis can be acute or subacute and any change in clinical status of a patient with a prosthetic valve should raise a suspicion of prosthetic valve thrombosis. Diagnosis entails detailed clinical examination and comprehensive imaging.

Dynamic, Time-Resolved CT Angiography After EVAR: A Quantitative Approach to Accurately Characterize Aortic Endoleak Type and Identify Inflow Vessels.

Purpose: Our purpose was to study the accuracy of dynamic computed tomography angiography (d-CTA) in characterizing endoleak type, inflow vessels as compared with digital subtraction angiography (DSA) using qualitative and quantitative analysis.

Methods: Between March 2019 and January 2021, all patients who underwent d-CTA imaging after EVAR were retrospectively reviewed. Two blinded independent reviewers qualitatively reviewed d-CTA and DSA images.

Time-resolved, Cardiac-gated Computed Tomography After Endovascular Ascending Aortic and Arch Repair.

Purpose: Better time-resolved imaging of stent grafts in the ascending aorta and arch accounting for cardiac motion is necessary to understand device-related complications and endoleaks. This report describes dynamic time-resolved computed tomographic angiography (d-CTA) and its combination with electrocardiography gating (d-gated CTA) to image stent grafts in the ascending aorta and to characterize endoleaks more clearly.

Description: d-CTA involves multiple scans acquired at different time points along the contrast enhancement curve.

Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging.

In the United States, more than 80% of all abdominal aortic aneurysms are treated by endovascular aortic aneurysm repair (EVAR). The endovascular approach warrants good early results, but adequate follow-up imaging after EVAR is imperative to maintain long-term positive outcomes. Potential graft-related complications are graft migration, infection, fraction, and endoleaks, with the last one being the most common.

Prognostic Value of Computed Tomography-Derived Fractional Flow Reserve Comparison With Myocardial Perfusion Imaging.

Objectives: The aim of this study was to compare the incremental prognostic value of coronary computed tomography (CT) angiography (CCTA)-derived machine learning fractional flow reserve CT (ML-FFRct) versus that of ischemia detected on single-photon emission-computed tomography (SPECT) myocardial perfusion imaging (MPI) on incident cardiovascular outcomes.

Background: SPECT MPI and ML-FFRct are noninvasive tools that can assess the hemodynamic significance of coronary atherosclerotic disease.

Methods: We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and SPECT MPI.

Added prognostic value of plaque burden to computed tomography angiography and myocardial perfusion imaging.

Background And Aims: Cardiac computed tomographic angiography (CCTA) - derived measures of coronary artery disease (CAD) burden have been shown to independently predict incident cardiovascular events. We aimed to compare the added prognostic value of plaque burden to CCTA anatomic assessment and single photon emission computed tomography (SPECT) physiologic assessment in a cohort with high prevalence of risk factors undergoing both tests.

Methods: Consecutive patients who underwent clinically indicated CCTA and SPECT myocardial imaging for suspected CAD were included.

Dynamic, Time-Resolved Computed Tomography Angiography Technique to Characterize Aortic Endoleak Type, Inflow and Provide Guidance for Targeted Treatment.

Purpose: To illustrate dynamic, time-resolved CTA (d-CTA) imaging technique in characterizing aortic endoleak type/inflow using quantitative parameters and its value in providing image guidance for targeted treatment approach.

Technique: Dedicated endoleak protocol involved acquiring multiple time-resolved contrast enhanced scans using third-generation CT scanner (Somatom Force, Siemens Healthineers). Parameters such as scan field of view (FOV), kV, number/timing of scans were customized based on patient's body-mass-index, timing bolus, and prior imaging findings.

Outcomes of patients with moderate-to-severe Ischemia excluded from the ischemia trial.

Background: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial showed no difference in outcomes between medical therapy vs coronary revascularization in the management of patients with stable coronary artery disease. We aimed to determine the percentage of patients with at least moderate ischemia that would have been eligible for enrollment and evaluate the outcomes of those who would not.

Methods: Consecutive patients who underwent cardiac single-photon emission computed tomography (SPECT) between April 2016 and September 2019 were identified and all-cause mortality was determined.