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Real-world application of CCTA with CT-FFR for coronary assessment pre-TAVI: the CT2TAVI study.
Int J Cardiovasc Imaging
January 2025
Cardiology, Endeavor NorthShore Cardiovascular Institute, Evanston, IL, USA.
This study aims to evaluate the implementation of concomitant CAD assessment on pre-TAVI (transcatheter aortic valve implantation) planning CTA (CT angiography) aided by CT-FFR (CT-fractional flow reserve) [The CT2TAVI protocol] and investigates the incremental value of CT-FFR to coronary CT angiography (CCTA) alone in the evaluation of patients undergoing CT2TAVI. This is a prospective observational real-world cohort study at an academic health system on consecutive patients who underwent CTA for TAVI planning from 1/2021 to 6/2022. This represented a transition period in our health system, from not formally reporting CAD on pre-TAVI planning CTA (Group A) to routinely reporting CAD on pre-TAVI CTA (Group B; CT2TAVI protocol).
View Article and Find Full Text PDFAdvances in Coronary CT Angiography: Applications and Implications for Coronary Artery Disease.
R I Med J (2013)
February 2025
Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence RI.
Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, necessitating advancements in diagnostic techniques. Coronary CT angiography (CCTA) has emerged as a pivotal non-invasive tool for evaluating coronary artery anatomy and detecting atherosclerotic plaque burden with high spatial resolution. This review explores the evolution of CCTA, highlighting its technological advancements, clinical applications, and challenges.
View Article and Find Full Text PDFEpicardial fat tissue, a hidden enemy against the early recovery of left ventricular systolic function after transcatheter aortic valve implantation.
Int J Cardiol Heart Vasc
February 2025
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Background: Epicardial fat tissue (EFT) is an active organ that can affect cardiac function and structure through endocrine, paracrine, and proinflammatory mechanisms. We hypothesized that greater thickness of EFT may harm the recovery of left ventricular (LV) systolic function in patients with severe aortic stenosis (AS) and reduced LV ejection fraction (EF ≤ 50 %) undergoing transcatheter aortic valve implantation (TAVI).
Methods: A sixty six patients with severe AS and 20 % ≥ LVEF ≤ 50 % who underwent TAVI were included.
Left Main Coronary Occlusion During TAVI Procedure: Calcium Embolization Matters.
Catheter Cardiovasc Interv
January 2025
Department of Cardiac Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Acute coronary occlusion during transcatheter aortic valve implantation (TAVI) is an unwarranted complication associated with high mortality. The current TAVI practices recommend a multidetector computed tomography (MDCT) evaluation of the aortic valve, the left ventricular outflow tract, and the aortic root to determine the conventional risk factors for coronary obstruction like low-lying coronary ostia and narrow sinuses of Valsalva, mandating prophylactic coronary protection or native valve leaflet modification in high-risk patients. Despite optimal anatomy, acute coronary occlusion can still occur due to multiple mechanisms, one of which is coronary embolism due to thrombus, calcium, or native aortic valve fragments.
View Article and Find Full Text PDFFeasibility analysis of non-electrocardiogram-triggered chest low-dose computed tomography using a kV-independent reconstruction algorithm for predicting cardiovascular disease risk in patients receiving maintenance hemodialysis.
BMC Cardiovasc Disord
January 2025
Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Objectives: This study aimed to evaluate the feasibility and accuracy of non-electrocardiogram (ECG)-triggered chest low-dose computed tomography (LDCT) with a kV-independent reconstruction algorithm in assessing coronary artery calcification (CAC) degree and cardiovascular disease risk in patients receiving maintenance hemodialysis (MHD).
Methods: In total, 181 patients receiving MHD who needed chest CT and coronary artery calcium score (CACS) scannings sequentially underwent non-ECG-triggered, automated tube voltage selection, high-pitch chest LDCT with a kV-independent reconstruction algorithm and ECG-triggered standard CACS scannings. Then, the image quality, radiation doses, Agatston scores (ASs), and cardiac risk classifications of the two scans were compared.
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