Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography

Area of Science:

• Cardiovascular Imaging
• Cardiac Surgery
• Radiology

Background:

• Aortic valve stenosis (AS) necessitates ruling out coronary artery disease (CAD) before surgical valve replacement.
• Preoperative assessment is crucial for surgical planning in AS patients.

Purpose of the Study:

• To evaluate the role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) in patients with AS.
• To assess the feasibility of 64-SCTA for ruling out CAD and evaluating the aortic valve and thoracic aorta prior to surgical valve replacement.

Main Methods:

• Forty-two patients with AS underwent ECG-gated 64-SCTA before surgery.
• Images were analyzed for aortic valve calcification, morphology, dimensions, and planimetry.
• Assessment included evaluation for CAD, thoracic aortic aneurysm, and left ventricle hypertrophy.

Main Results:

• 64-SCTA provided clear visualization of the aortic valve in 90.5% of patients.
• Accurate assessment of valvular morphology, calcification grading, and annular/junctional diameters was achieved in 100% of cases.
• Ascending aortic aneurysms were detected in 28.6%, and left ventricle hypertrophy in 71% of patients.

Conclusions:

• Preoperative 64-SCTA is feasible for patients undergoing surgical AS replacement.
• This imaging technique effectively rules out CAD and provides essential information on the aortic valve and thoracic aorta for surgical planning.