ACR Appropriateness Criteria® Preprocedural Chest or Cardiac Imaging for Cardiothoracic Surgery

Area of Science:

• Cardiothoracic Surgery
• Radiology
• Medical Imaging

Background:

• Preprocedural imaging is crucial for planning cardiothoracic surgeries, considering patient comorbidities and anesthesia risks.
• Diverse surgical procedures (coronary, noncoronary cardiac, thoracic) have unique imaging needs, varying for first-time versus repeat surgeries.
• This review synthesizes literature on preprocedural chest and cardiac imaging for patients with and without prior cardiothoracic surgery.

Purpose of the Study:

• To review the current literature on preprocedural chest and cardiac imaging for cardiothoracic surgery.
• To provide evidence-based guidelines for appropriate imaging selection in various cardiothoracic surgical contexts.
• To address imaging needs for both primary and repeat cardiothoracic procedures.

Main Methods:

• Systematic literature review of preprocedural imaging for cardiothoracic surgery.
• Application of the American College of Radiology Appropriateness Criteria methodology.
• Adaptation of evidence evaluation principles like Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
• Utilization of the RAND/UCLA Appropriateness Method for determining imaging procedure suitability.
• Inclusion of expert opinion where peer-reviewed literature is limited or inconclusive.

Main Results:

• Identified specific imaging requirements for different types of cardiothoracic surgeries.
• Highlighted variations in imaging needs based on surgical history (first-time vs. repeat).
• Established a framework for selecting appropriate imaging based on clinical scenarios and evidence.

Conclusions:

• Preprocedural imaging selection for cardiothoracic surgery requires careful consideration of surgical type, patient history, and available evidence.
• Evidence-based guidelines and expert consensus are essential for optimizing imaging practices.
• The review provides a foundation for refining appropriateness criteria in cardiothoracic imaging.