CIVIT Test Site

October 2008

March 2008

Next issue March 2009

Introduction

Stephan Achenbach, MD, FACC, FESC, Department of Cardiology, University of Erlangen, Erlangen, Germany

The success story of cardiac computed tomography (CT) imaging continues to unfold. On one hand, technology keeps evolving at a rapid pace, and, on the other hand, well-designed research studies provide evidence concerning the clinical use of coronary CT angiography and other aspects of cardiac CT. view article

Acute chest pain in the emergency department: Role of cardiac CTA

Charles S. White, MD, Professor of Radiology and Medicine and Chief of Thoracic Radiology, Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, MD.

The assessment of patients with acute chest pain in the emergency department is a challenge, and the existing evaluation is not optimized. This article reviews the conventional noninvasive imaging evaluation and describes the current status of cardiac CT angiography for this indication. The 2 major competing chest pain protocols—dedicated cardiac CT angiography and triple rule-out chest CT—are described in detail, and their advantages and limitations are compared. view article

Applications of cardiac CT in electrophysiology interventions

Laurens F. Tops, MD, Joanne D. Schuijf, MSc, PhD, and Jeroen J. Bax, MD, PhD, FACC, FESC, Leiden University Medical Center, The Netherlands

Electrophysiological interventions, such as catheter ablation procedures for atrial fibrillation and cardiac resynchronization therapy, require detailed knowledge of cardiac anatomy. Multislice computed tomography (CT) allows accurate visualization of the pulmonary veins, coronary venous system, and other critical structures. Thereby, it provides an “anatomical roadmap” for electrophysiological interventions. Recently, new techniques have become available that allow the integration of multislice CT with other imaging modalities. The authors review the role of multislice CT in electrophysiological interventions. view article

Preoperative risk assessment using coronary CTA in a patient with aortic valve endocarditis

Manju Goyal, MD, Todd C. Villines, MD, Lance E. Sullenberger, MD, Eddie Hulten, MD, MPH, and Irwin M. Feuerstein, MD

The American College of Cardiology/American Heart Association 2006 guidelines recommend invasive coronary angiography before valve surgery in men aged ≥35 years, premenopausal women ≥35 years with any coronary risk factor, and postmenopausal women. However, conventional coronary angiography is associated with a small risk of serious complications related to its invasive nature. Additionally, there is a small risk of septic embolism during invasive catheterization in patients with aortic valve endocarditis. The authors report a case in which 64-slice multidetector CT angiography was used to assess risk prior to valve surgery in a 54-year-old man with aortic valve endocarditis. view article