Difference between revisions of "CT of the heart before surgery or intervention"
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==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== | ==Evaluation== | ||
Latest revision as of 09:44, 19 July 2019
Authors:
Mikael Häggström; Authors of integrated Creative Commons article[1] [notes 1]
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.
