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- Title
Contrast volume reduction using third generation dual source computed tomography for the evaluation of patients prior to transcatheter aortic valve implantation.
- Authors
Bittner, Daniel; Arnold, Martin; Klinghammer, Lutz; Schuhbaeck, Annika; Hell, Michaela; Muschiol, Gerd; Gauss, Soeren; Achenbach, Stephan; Marwan, Mohamed; Lell, Michael; Uder, Michael; Hoffmann, Udo; Bittner, Daniel O; Hell, Michaela M
- Abstract
<bold>Objectives: </bold>Chronic renal failure is common in patients referred for transcatheter aortic valve implantation (TAVI). CT angiography is recommended and provides crucial information prior to TAVI. We evaluated the feasibility of a reduced contrast volume protocol for pre-procedural CT imaging.<bold>Methods: </bold>Forty consecutive patients were examined with prospectively ECG-triggered high-pitch spiral acquisition using a novel third-generation dual-source CT system; 38 ml contrast agent was used. Image quality was graded on a visual scale (1-4). Contrast attenuation was measured at the level of the aortic root and at the iliac bifurcation.<bold>Results: </bold>Mean patient age was 82 ± 6 years (23 males; 58 %). Mean attenuation/average image quality was 285 ± 60 HU/1.5 at the aortic annulus compared to 289 ± 74 HU/1.8 at the iliac bifurcation (p = 0.77/p = 0.29). Mean estimated effective radiation dose was 2.9 ± 0.3 mSv. A repeat acquisition was necessary in one patient due to image quality. Out of the 35 patients who underwent TAVI, 31 (89 %) patients had no or mild aortic regurgitation. Thirty-two (91 %) patients were discharged successfully.<bold>Conclusion: </bold>Pre-procedural CTA with a total of 38 ml contrast volume is feasible and clinically useful, using third-generation dual-source CT, allowing comprehensive imaging for procedural success.<bold>Key Points: </bold>• Reduction of contrast agent volume is crucial in patients with chronic renal failure. • Novel third-generation computed tomography helps to reduce contrast agent volume. • Pre-procedural CT allows comprehensive imaging for procedural success before heart valve implantation. • A low-contrast CT protocol is feasible for pre-procedural TAVI planning.
- Subjects
AORTIC valve surgery; COMPUTED tomography; KIDNEY failure; CONTRAST media; HEART valve transplantation
- Publication
European Radiology, 2016, Vol 26, Issue 12, p4497
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4320-8