Abstract 2409: Simultaneous Assessment of Aortic Valve Area and Coronary Artery Stenosis Using 64-row Multidetector Computed Tomography
Background: Recent advancement of 64-row multidetector computed tomography (64-MDCT) provides noninvasive assessments not only on coronary artery trees, but also on left ventricular shape and valvular morphologies. Since patients with aortic stenosis have a higher prevalence of coronary artery stenoses, clinical evaluation of coronary lesions is essential to avoid unexpected clinical outcomes especially in elder patients. The aim of this study was to assess the feasibility to measure AVA and coronary artery stenoses simultaneously by using 64-MDCT.
Methods: Fifteen patients with aortic stenosis underwent 64-MDCT (LightSpeed VCT Select, GE Yokogawa Medical Inc), transthorachic echocardiography (TTE), and invasive angiography. Contrast enhanced 64-MDCT images were acquired and AVA was reconstructed at cross-sectional transverse level at mid systole of the ECG gating cardiac cycle. AVA was measured by planimetry. The values were compared to those calculated by the continuity equation using TTE. The coronary tree of each patient was evaluated and screened for >75% diameter stenosis by two blinded observers and compared with invasive angiography.
Results: AVAs measured by 64-MDCT were very close to those measured by TTE (0.89±0.41 cm2 vs 0.78±0.41 cm2), and regression analysis showed significant correlation between 64-MDCT and TTE(R=0.93, p<0.005). Invasive angiography revealed 5 out of 15 patients have significant coronary stenoses. Except 3 patients who were inadequate to evaluate by 64-MDCT because of massive calcification, sensitivity, specificity, positive and negative predictive values to identify the presence of significant coronary stenosis were: 1.00, 0.88, 0.80, 1.00, respectively.
Conclusion: Using 64-MDCT, noninvasive and simultaneous assessments of AVA and coronary artery stenoses are possible in patients with aortic stenosis.