Difference between revisions of "CT of the heart before surgery or intervention"

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|author1=[[User:Mikael Häggström|Mikael Häggström]]
 
|author1=[[User:Mikael Häggström|Mikael Häggström]]
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|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>
 
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==Planning==
 
==Planning==
 
{{Heart imaging before surgery or intervention - choice of modality}}
 
{{Heart imaging before surgery or intervention - choice of modality}}
 +
 +
==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
 
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Revision as of 09:32, 19 July 2019

Authors: Mikael Häggström; Authors of integrated Creative Commons article[1] [notes 1]

Planning

Choice of modality

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

  1. 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.

References

  1. 1.0 1.1 1.2 1.3 Rajiah, Prabhakar; Schoenhagen, Paul (2013). "The role of computed tomography in pre-procedural planning of cardiovascular surgery and intervention ". Insights into Imaging 4 (5): 671–689. doi:10.1007/s13244-013-0270-8. ISSN 1869-4101.