Difference between revisions of "CT of the heart before surgery or intervention"
Jump to navigation
Jump to search
(Started) |
(+Settings) |
||
| (2 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
{{Top | {{Top | ||
|author1=[[User:Mikael Häggström|Mikael Häggström]] | |author1=[[User:Mikael Häggström|Mikael Häggström]] | ||
| − | |author2= | + | |author2=Authors of integrated Creative Commons article<ref name="RajiahSchoenhagen2013">{{cite journal|last1=Rajiah|first1=Prabhakar|last2=Schoenhagen|first2=Paul|title=The role of computed tomography in pre-procedural planning of cardiovascular surgery and intervention|journal=Insights into Imaging|volume=4|issue=5|year=2013|pages=671–689|issn=1869-4101|doi=10.1007/s13244-013-0270-8}}</ref> |
}} | }} | ||
==Planning== | ==Planning== | ||
{{Heart imaging before surgery or intervention - choice of modality}} | {{Heart imaging before surgery or intervention - choice of modality}} | ||
| + | ===Settings=== | ||
| + | *'''Prospective ECG triggering''' is used in most instances, which is associated with significant reduction in radiation dose.<ref name="RajiahSchoenhagen2013"/> | ||
| + | *'''Retrospective ECG-gated acquisition''' (with dose modulation) is mostly limited to situations when information from all the phases of cardiac cycle is required, particularly for 4D imaging. Another indication is a patient with high and irregular heart rate.<ref name="RajiahSchoenhagen2013"/> | ||
| + | *'''Non-ECG-gated''' scanning is used to reduce radiation dose if motion artefact is not a major concern, e.g. for left atrial assessment in patients with atrial fibrillation.<ref name="RajiahSchoenhagen2013"/> | ||
| + | |||
| + | ==Evaluation== | ||
| + | Depending on procedure:<ref name="RajiahSchoenhagen2013"/> | ||
| + | |||
| + | ;Re-operative cardiothoracic surgery | ||
| + | *Relationship of cardiovascular structures to sternum. | ||
| + | *Relationship of coronary bypass grafts to sternum | ||
| + | *Atherosclerotic calcification of ascending aorta | ||
| + | *Anatomy of subclavian & axillary arteries and aortic arch | ||
| + | ;Percutaneous aortic valve | ||
| + | *Aortic root dimensions | ||
| + | *LV outflow tract: size; septal thickness | ||
| + | *Leaflet morphology/calcification | ||
| + | *Valve area | ||
| + | *Leaflet opening | ||
| + | *Distance between annulus and coronary ostia | ||
| + | *Leaflet length | ||
| + | *Relationship of aortic root to body axis | ||
| + | *Caliber and contour of access vessels | ||
| + | ;Pulmonary venous ablation | ||
| + | *Pulmonary venous anatomy | ||
| + | *Branching pattern | ||
| + | *Orientation | ||
| + | *Ostial size and pulmonary venous stenosis | ||
| + | *Left atrial dimensions | ||
| + | *Thrombus | ||
| + | *Relationship to oesophagus | ||
| + | ;Robotic mitral valve repair | ||
| + | *Annulus and leaflet morphology | ||
| + | *Mitral annular calcification | ||
| + | *Annulus dimensions | ||
| + | *Calibre of femoral vessels | ||
| + | *Atherosclerosis of access vessels | ||
| + | *Distance from sinotubular junction to arch | ||
| + | ;Cardiac resynchronisation therapy | ||
| + | *Coronary venous anatomy | ||
| + | *Scar in lateral wall | ||
| + | ;Percutaneous mitral annuloplasty | ||
| + | *Distance between coronary sinus/GCV and annulus | ||
| + | *LCX between CS-GCV and annulus | ||
| + | *Calcification of mitral annulus | ||
| + | ;Atrial septal defect closure | ||
| + | *Type of defect | ||
| + | *Size of defect | ||
| + | *Rim of defect | ||
| + | *Associated cardiovascular anomalies | ||
| + | *Thrombus | ||
| + | ;Ventricular septal defect closure | ||
| + | *Type of defect | ||
| + | *Size of defect | ||
| + | *Shape of defect | ||
| + | *Proximity to valves and AV conduction bundle | ||
| + | ;Endovascular stent grafts | ||
| + | *Measurement of the primary pathology | ||
| + | *Maximal aortic diameter at the landing zone/neck | ||
| + | *Thrombus/atheroma in the landing zone | ||
| + | *Distance from major branch vessel | ||
| + | *Angulation at diaphragm | ||
| + | *Calibre of femoral/iliac arteries | ||
| + | ;Percutaneous pulmonary valve implantation | ||
| + | *Calibre of RV-PA conduit | ||
| + | *Length of the conduit available from pulmonary artery bifurcation | ||
| + | *RVOT/pulmonary trunk morphology | ||
| + | *Position of proximal coronary arteries | ||
{{Bottom}} | {{Bottom}} | ||
Latest revision as of 09:44, 19 July 2019
Authors:
Mikael Häggström; Authors of integrated Creative Commons article[1] [notes 1]
Contents
Planning
Choice of modality
- Echocardiography is generally the first imaging modality for valvular surgery or vascular intervention.[1]
- CT of the heart before surgery or intervention provides anatomic mapping, including extra-cardiac structures.[1]
Settings
- Prospective ECG triggering is used in most instances, which is associated with significant reduction in radiation dose.[1]
- Retrospective ECG-gated acquisition (with dose modulation) is mostly limited to situations when information from all the phases of cardiac cycle is required, particularly for 4D imaging. Another indication is a patient with high and irregular heart rate.[1]
- Non-ECG-gated scanning is used to reduce radiation dose if motion artefact is not a major concern, e.g. for left atrial assessment in patients with atrial fibrillation.[1]
Evaluation
Depending on procedure:[1]
- Re-operative cardiothoracic surgery
- Relationship of cardiovascular structures to sternum.
- Relationship of coronary bypass grafts to sternum
- Atherosclerotic calcification of ascending aorta
- Anatomy of subclavian & axillary arteries and aortic arch
- Percutaneous aortic valve
- Aortic root dimensions
- LV outflow tract: size; septal thickness
- Leaflet morphology/calcification
- Valve area
- Leaflet opening
- Distance between annulus and coronary ostia
- Leaflet length
- Relationship of aortic root to body axis
- Caliber and contour of access vessels
- Pulmonary venous ablation
- Pulmonary venous anatomy
- Branching pattern
- Orientation
- Ostial size and pulmonary venous stenosis
- Left atrial dimensions
- Thrombus
- Relationship to oesophagus
- Robotic mitral valve repair
- Annulus and leaflet morphology
- Mitral annular calcification
- Annulus dimensions
- Calibre of femoral vessels
- Atherosclerosis of access vessels
- Distance from sinotubular junction to arch
- Cardiac resynchronisation therapy
- Coronary venous anatomy
- Scar in lateral wall
- Percutaneous mitral annuloplasty
- Distance between coronary sinus/GCV and annulus
- LCX between CS-GCV and annulus
- Calcification of mitral annulus
- Atrial septal defect closure
- Type of defect
- Size of defect
- Rim of defect
- Associated cardiovascular anomalies
- Thrombus
- Ventricular septal defect closure
- Type of defect
- Size of defect
- Shape of defect
- Proximity to valves and AV conduction bundle
- Endovascular stent grafts
- Measurement of the primary pathology
- Maximal aortic diameter at the landing zone/neck
- Thrombus/atheroma in the landing zone
- Distance from major branch vessel
- Angulation at diaphragm
- Calibre of femoral/iliac arteries
- Percutaneous pulmonary valve implantation
- Calibre of RV-PA conduit
- Length of the conduit available from pulmonary artery bifurcation
- RVOT/pulmonary trunk morphology
- Position of proximal coronary arteries
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
