Aortic stenosis CT: Difference between revisions
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* CT scan is costly. | * CT scan is costly. | ||
* Radiation can have long terms side-effect on growing children. | * Radiation can have long terms side-effect on growing children. | ||
== 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines<ref name="pmid33332150">{{cite journal| author=Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F | display-authors=etal| title=2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 143 | issue= 5 | pages= e72-e227 | pmid=33332150 | doi=10.1161/CIR.0000000000000923 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33332150 }}</ref> == | |||
=== Recommendations for Diagnostic Testing: Initial Diagnosis of AS Referenced studies that support the recommendations are summarized in Online Data Supplement === | |||
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| colspan="1" style="text-align:center; background:LemonChiffon" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
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| bgcolor="LemonChiffon" |5. In patients with suspected low-flow, low-gradient severe AS with normal or reduced LVEF (Stages D2 and D3), measurement of aortic valve calcium score by CT imaging is reasonable to further define severity.([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: B-NR'']]) | |||
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==References== | ==References== | ||
Latest revision as of 03:17, 8 December 2022
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Resident Survival Guide |
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Aortic Stenosis Microchapters |
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Diagnosis |
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Treatment |
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Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty |
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Transcatheter Aortic Valve Replacement (TAVR) |
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Case Studies |
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Aortic stenosis CT On the Web |
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American Roentgen Ray Society Images of Aortic stenosis CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, MBBS [2]; Mohammed A. Sbeih, M.D. [3]; Usama Talib, BSc, MD [4] Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]
Overview
Computed tomography can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.[1]
CT Scan
Shown below is the plain CT of a patient with supravalvular aortic stenosis. The image shows an almost circular supravalvular aortic calcification of the aortic wall with extension of calcifications into the left main stem. The area of calcification is shown in yellow.
Advantages
Following are a few advantages of the use of CT in Aortic Stenosis.[2]
- CT scan provides additional anatomic details compared to echocardiography.
- It may allow quantitattion of chamber sizes and calcification of the aortic valve.
- The presence of calcification is a marker of hemodynamic severity, particularly in the younger patient.
- It is done faster compared to MRI, thus avoiding the need for anesthesia in small children.
Disadvantages
- CT scan is costly.
- Radiation can have long terms side-effect on growing children.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[3]
Recommendations for Diagnostic Testing: Initial Diagnosis of AS Referenced studies that support the recommendations are summarized in Online Data Supplement
| Class IIa |
| 5. In patients with suspected low-flow, low-gradient severe AS with normal or reduced LVEF (Stages D2 and D3), measurement of aortic valve calcium score by CT imaging is reasonable to further define severity.(Level of Evidence: B-NR) |
References
- ↑ F. Ciolina, P. Sedati, F. Zaccagna, N. Galea, V. Noce, F. Miraldi, E. Cavarretta, M. Francone & I. Carbone (2015). "Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography". The Journal of cardiovascular surgery. 56 (5): 799–808. PMID 26088011. Unknown parameter
|month=ignored (help) - ↑ Christopher J. Bennett, Joseph J. Maleszewski & Philip A. Araoz (2012). "CT and MR imaging of the aortic valve: radiologic-pathologic correlation". Radiographics : a review publication of the Radiological Society of North America, Inc. 32 (5): 1399–1420. doi:10.1148/rg.325115727. PMID 22977027. Unknown parameter
|month=ignored (help) - ↑ Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F; et al. (2021). "2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 143 (5): e72–e227. doi:10.1161/CIR.0000000000000923. PMID 33332150 Check
|pmid=value (help).