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Bredin F, Franco-Cereceda A. Long-term follow-up of passive containment surgery in patients with aortic regurgitation. Interact Cardiovasc Thorac Surg 2021; 34:999-1001. [PMID: 34664073 PMCID: PMC9159436 DOI: 10.1093/icvts/ivab273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/23/2021] [Accepted: 08/13/2021] [Indexed: 11/20/2022] Open
Abstract
The goal of this case-control study was to evaluate the long-term effects on cardiac dimensions, cardiac function and coronary circulation in patients with aortic regurgitation (AR) and left ventricular dilatation undergoing aortic valve replacement and application of the Acorn CorCap cardiac support device Of 10 patients with AR and ventricular dilatation who had a mechanical aortic valve implanted, 5 in addition received the cardiac support device. Cardiac dimensions and cardiac function were measured by echocardiography preoperatively and 1, 5 and 10 years postoperatively. The coronary circulation was assessed by computed tomography angiography. After aortic valve replacement, there was a rapid and sustained decrease in cardiac dimensions. This result did not differ after application of the cardiac support device. Improvement in cardiac function remained unchanged in both groups at the 10-year follow-up. None of the patients had developed any signs of coronary artery disease. Application of the Acorn CorCap cardiac support device in patients with AR and left ventricular dilatation did not add to the reversed remodelling or cardiac function at the long-term follow-up compared to aortic valve replacement alone.
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Affiliation(s)
- Fredrik Bredin
- Section of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Section of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Canan A, Ranganath P, Goerne H, Abbara S, Landeras L, Rajiah P. CAD-RADS: Pushing the Limits. Radiographics 2020; 40:629-652. [PMID: 32281902 DOI: 10.1148/rg.2020190164] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Coronary CT angiography is now established as the first-line diagnostic imaging test to exclude coronary artery disease (CAD) in the population at low to intermediate risk. Wide variability exists in both the reporting of coronary CT angiography and the interpretation of these reports by referring physicians. The CAD Reporting and Data System (CAD-RADS) is sponsored by multiple societies and is a collaborative effort to provide standard classification of CAD, which is then integrated into patient clinical care. The main goals of the CAD-RADS are to decrease variability among readers; enhance communication between interpreting and referring clinicians, allowing collaborative determination of the best course of patient care; and generate consistent data for auditing, data mining, quality improvement, research, and education. There are several scenarios in which the CAD-RADS guidelines are ambiguous or do not provide definite recommendations for further management of CAD. The authors discuss the CAD-RADS categories and modifiers, highlight a variety of complex or ambiguous scenarios, and provide recommendations for managing these scenarios. Online supplemental material is available for this article. ©RSNA, 2020 See discussion on this article by Aviram and Wolak.
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Affiliation(s)
- Arzu Canan
- From the Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Tex (A.C., P. Ranganath, H.G., S.A., P. Rajiah); Imaging and Diagnosis Center, Guadalajara, Mexico (H.G.); and Department of Radiology, University of Chicago Medical Center, Chicago, Ill (L.L.)
| | - Praveen Ranganath
- From the Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Tex (A.C., P. Ranganath, H.G., S.A., P. Rajiah); Imaging and Diagnosis Center, Guadalajara, Mexico (H.G.); and Department of Radiology, University of Chicago Medical Center, Chicago, Ill (L.L.)
| | - Harold Goerne
- From the Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Tex (A.C., P. Ranganath, H.G., S.A., P. Rajiah); Imaging and Diagnosis Center, Guadalajara, Mexico (H.G.); and Department of Radiology, University of Chicago Medical Center, Chicago, Ill (L.L.)
| | - Suhny Abbara
- From the Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Tex (A.C., P. Ranganath, H.G., S.A., P. Rajiah); Imaging and Diagnosis Center, Guadalajara, Mexico (H.G.); and Department of Radiology, University of Chicago Medical Center, Chicago, Ill (L.L.)
| | - Luis Landeras
- From the Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Tex (A.C., P. Ranganath, H.G., S.A., P. Rajiah); Imaging and Diagnosis Center, Guadalajara, Mexico (H.G.); and Department of Radiology, University of Chicago Medical Center, Chicago, Ill (L.L.)
| | - Prabhakar Rajiah
- From the Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Tex (A.C., P. Ranganath, H.G., S.A., P. Rajiah); Imaging and Diagnosis Center, Guadalajara, Mexico (H.G.); and Department of Radiology, University of Chicago Medical Center, Chicago, Ill (L.L.)
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Koplay M, Guneyli S, Akbayrak H, Demir K, Sivri M, Avci A, Erdogan H, Paksoy Y. Diagnostic accuracy and effective radiation dose of high pitch dual source multidetector computed tomography in evaluation of coronary artery bypass graft patency. Wien Klin Wochenschr 2016; 128:488-94. [PMID: 27343083 DOI: 10.1007/s00508-016-1030-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the diagnostic accuracy and effective radiation dose (ERD) of high pitch dual source multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency. MATERIALS AND METHODS Fourty-five patients who underwent 128 × 2‑slice MDCT angiography with a prospective electrocardiogram-triggering, low-dose, high pitch, dual source, flash spiral acquisition mode after CABG surgery were included in the study. The interobserver agreement of the image quality was evaluated with Cohen κ value. The image quality was compared to the heart rates (HRs) using Mann-Whitney U test and to the graft segments using χ(2) test. The findings for the CABG patency on MDCT were compared to those determined on catheter coronary angiography. Dose-length product (DLP) and ERD were compared to the gender, HRs, and body mass index (BMI) of the patients using Kruskall Wallis and Mann-Whitney U tests. RESULTS A total of 110 grafts and 330 vessel segments were evaluated with a good interobserver agreement (κ = 0.80). The image quality was better in proximal and middle graft segments (p < 0.05), as well as in the patients with low HRs (p < 0.05). High pitch MDCT had the following sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for evaluation of graft patency: 92.8, 99.3, 92.8, 99.3 and 98.8 %, respectively. ERD was correlated to the HRs and BMI. CONCLUSIONS High pitch 128 × 2‑slice dual source CT angiography is a noninvasive imaging modality, and it can be safely and effectively used in evaluation of CABG patency with lower radiation dose.
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Affiliation(s)
- Mustafa Koplay
- Department of Radiology, Medical Faculty, Selcuk University, The Central Campus, 42075, Konya, Turkey.
| | - Serkan Guneyli
- Department of Radiology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey
| | - Hakan Akbayrak
- Department of Cardiovascular Surgery, Medical Faculty, Selcuk University, Konya, Turkey
| | - Kenan Demir
- Department of Cardiology, Medical Faculty, Selcuk University, Konya, Turkey
| | - Mesut Sivri
- Department of Radiology, Medical Faculty, Selcuk University, The Central Campus, 42075, Konya, Turkey
| | - Ahmet Avci
- Department of Cardiology, Medical Faculty, Selcuk University, Konya, Turkey
| | - Hasan Erdogan
- Department of Radiology, Medical Faculty, Selcuk University, The Central Campus, 42075, Konya, Turkey
| | - Yahya Paksoy
- Department of Radiology, Medical Faculty, Selcuk University, The Central Campus, 42075, Konya, Turkey
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Abstract
As laparoscopic surgery is replacing open surgery, similarly computed tomography angiography is replacing invasive conventional cardiac angiography. In the last century, marvelous efforts in research have improved strategies for cure, diagnosis and prevention of fatal human diseases; however, coronary artery disease, as the most prevalent cause of mortality and morbidity in the world, has remained a great challenge. Due to advancements in technology and research, it has become more simple and robust to diagnose and treat coronary artery disease (CAD) with minimal or no intervention, promising to not only diagnosis at an early stage but potential prevention altogether. While most with obvious CAD can be diagnosed easily and quickly with ECG, those identified as 'low risk' require more extensive testing to diagnose or rule out CAD. For example in emergency departments, low-risk patients with chest pain are diagnosed solely depending on history, ECG and blood testing for biomarkers. This approach has resulted in either delayed or miss-diagnosis of Acute coronary syndrome. To prevent this, many emergency departments now use protocols for low-risk heart patients that include cardiac stress tests and/or CT heart imaging. This review provides an overview of the current literature on the value of Computed tomography angiography and discusses how prognostic information obtained with Computed tomography angiography can be used to further integrate the technique into clinical practice.
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Affiliation(s)
- Muhammad A Latif
- St. John Cardiovascular Research Center, Los Angeles Biomedical Research Institute, Torrance, CA, USA
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