Abstract 16783: Diagnostic Accuracy of Coronary Computed Tomography Angiography in Patients Undergoing Cardiac Valve Surgery: Systematic Review and Meta-analysis
Introduction: The objective of this study is to investigate the diagnostic accuracy of coronary computed tomography angiography (CCTA) in patients undergoing cardiac valve surgery using invasive coronary angiography (ICA) as gold standard.
Hypothesis: CCTA is accurate for identification of significant coronary stenosis in cardiac valve surgery patients
Methods: We search databases for all diagnostic studies of CCTA in patients undergoing cardiac valve surgery which reported diagnostic testing characteristics required to pool summary sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Significant stenosis in both CCTA and ICA is defined by >50% stenosis in any coronary artery, in-stent stenosis or bypass graft.
Results: Nine studies evaluated 659 patients (mean age = 66 years, 52% men). The pooled prevalence of significant stenosis determined by ICA is 25% (range 18%-56%). Summary receiver operating characteristic (sROC) analysis demonstrates a summary area under curve (sAUC) of 0.97. The pooled sensitivity and negative likelihood ratio of CCTA in identifying significant stenosis determined by ICA are 96% and 0.07 without significant inter-study heterogeneity. The pooled specificity and positive likelihood ratio are 89% and 7.36 with mild-moderate inter-study heterogeneity.
Conclusions: In patients undergoing cardiac valve surgery, CCTA has excellent sensitivity and negative likelihood ratio to exclude significant coronary stenosis. Our meta-analysis supports the role of preoperative computed tomography as a rule-out test in this population.
Author Disclosures: K. Chaikriangkrai: None. G. Palamaner Subash Shanta: None. A. Bin Abdulhak: None. H. Jhun: None. J.K. Bhama: None. G. Sigurdsson: None.
- © 2016 by American Heart Association, Inc.