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| [[File:Siren.gif|30px|link=Aortic stenosis resident survival guide]]|| <br> || <br>
| [[Aortic stenosis resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|}
{{Template:Aortic stenosis}}
{{Template:Aortic stenosis}}
{{CMG}}


'''Associate Editors-In-Chief:''' Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]; [[User:Abdarabi|Abdul-Rahman Arabi, M.D.]] [mailto:abdarabi@yahoo.com]; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]; [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{USAMA}} '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu]


=='''Overview'''==
==Overview==
Computed tomography can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.
Computed tomography can be helpful as a diagnostic tool in conditions where the [[echocardiographic]] findings are inconclusive.<ref>{{Cite journal
| author = [[F. Ciolina]], [[P. Sedati]], [[F. Zaccagna]], [[N. Galea]], [[V. Noce]], [[F. Miraldi]], [[E. Cavarretta]], [[M. Francone]] & [[I. Carbone]]
| title = Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography
| journal = [[The Journal of cardiovascular surgery]]
| volume = 56
| issue = 5
| pages = 799–808
| year = 2015
| month = October
| pmid = 26088011
}}</ref>


==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.


=='''Computed tomography'''==  
[[Image:Plain ct.jpg|center|500px]]
===Advantages===
Following are a few advantages of the use of CT in Aortic Stenosis.<ref>{{Cite journal
| author = [[Christopher J. Bennett]], [[Joseph J. Maleszewski]] & [[Philip A. Araoz]]
| title = CT and MR imaging of the aortic valve: radiologic-pathologic correlation
| journal = [[Radiographics : a review publication of the Radiological Society of North America, Inc]]
| volume = 32
| issue = 5
| pages = 1399–1420
| year = 2012
| month = September-October
| doi = 10.1148/rg.325115727
| pmid = 22977027
}}</ref>
* 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.


Computed tomography (CT) can be used as a diagnostic modality in congenital heart diseases.  
===Disadvantages===
* CT scan is costly.
* Radiation can have long terms side-effect on growing children.


'''Advantages
== 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> ==


* Provides additional anatomic details compared to echocardiography
=== Recommendations for Diagnostic Testing: Initial Diagnosis of AS Referenced studies that support the recommendations are summarized in Online Data Supplement ===
* It is done faster compared to MRI, thus avoiding the need for anesthesia in small children.  
{| class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| 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'']])
|}


'''Disadvantage'''
* Costly
* Radiation can have long terms side-effect on growing children.
==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:DiseaseState]]
{{WH}}
[[Category:Signs and symptoms]]
{{WS}}
[[Category:Physical Examination]]
[[CME Category::Cardiology]]
 
[[Category:Disease]]
[[Category:Valvular heart disease]]
[[Category:Valvular heart disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Congenital heart disease]]
[[Category:Congenital heart disease]]
[[Category:Pediatrics]]
[[Category:Cardiac surgery]]
 
[[Category:Surgery]]
{{WH}}
{{WS}}

Latest revision as of 03:17, 8 December 2022
Resident
Survival
Guide

Aortic Stenosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Aortic Stenosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Cardiac Stress Test

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography

Cardiac Catheterization

Aortic Valve Area

Aortic Valve Area Calculation

Treatment

General Approach

Medical Therapy

Surgery

Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty

Transcatheter Aortic Valve Replacement (TAVR)

TAVR vs SAVR
Critical Pathway
Patient Selection
Imaging
Evaluation
Valve Types
TAVR Procedure
Post TAVR management
AHA/ACC Guideline Recommendations

Follow Up

Prevention

Precautions and Prophylaxis

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Aortic stenosis CT On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Aortic stenosis CT

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Aortic stenosis CT

CDC on Aortic stenosis CT

Aortic stenosis CT in the news

Blogs on Aortic stenosis CT

Directions to Hospitals Treating Aortic stenosis CT

Risk calculators and risk factors for 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

  1. ↑ 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)
  2. ↑ 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)
  3. ↑ 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).

Template:WH Template:WS CME Category::Cardiology

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