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Gianluca Pontone,
Daniele Andreini,
Antonio L Bartorelli,
Erika Bertella,
Sarah Cortinovis,
Saima Mushtaq,
Andrea Annoni, Alberto Formenti,
Andrea Baggiano,
Edoardo Conte,
Gloria Tamborini,
Manuela Muratori,
Paola Gripari,
Francesca Bovis,
Fabrizio Veglia,
Claudia Foti,
Francesco Alamanni,
Giovanni Ballerini,
Cesare Fiorentini,
Mauro Pepi
[show abstract]
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ABSTRACT: Transcatheter aortic valve implantation (TAVI) is a valid alternative to surgery in high-risk patients with severe aortic stenosis. Aortic annulus (AoA) sizing is crucial for TAVI success. The aim of the study was to compare AoA dimensions measured by multidetector computed tomography (MDCT) vs those obtained with transthoracic (TTE) and transesophageal echocardiography (TEE) for predicting paravalvular aortic regurgitation (PVR) after TAVI.
Aortic annulus maximum diameter, minimum diameter, and area were assessed using MDCT and compared with TTE and TEE diameter and area for predicting PVR after TAVI in 151 patients (45 men, age 81.2 ± 6.4 years).
Aortic annulus maximum, minimum diameter, and area detected by MDCT were 25.04 ± 2.39 mm, 21.27 ± 2.10 mm, and 420.87 ± 76.10 mm(2), respectively. Aortic annulus diameter and area measured by TTE and TEE were 21.14 ± 1.94 mm and 353.82 ± 64.57 mm(2) and 22.04 ± 1.94 mm and 384.33 ± 67.30 mm(2), respectively. A good correlation was found between AoA diameters and area evaluated by MDCT vs TTE and TEE (0.61, 0.65, and 0.69 and 0.61, 0.65, and 0.70, respectively), with a mean difference of 3.90 ± 1.98 mm, 0.13 ± 1.67 mm, and 67.05 ± 55.87 mm(2) and 3.0 ± 2.0 mm, 0.77 ± 1.70 mm, and 36.54 ± 56.43 mm(2), respectively. Grade ≥2 PVR occurred in 46 patients and was related to male gender, higher body mass index, preprocedural aortic regurgitation, and lower mismatch between the nominal area of the implanted prosthesis and AoA area detected by MDCT.
Mismatch between prosthesis area and AoA area detected by MDCT is a better predictor of PVR as compared with echocardiography mismatch. Specific MDCT-based sizing recommendations should be developed.
American heart journal 10/2012; 164(4):576-84. · 4.65 Impact Factor
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Gianluca Pontone,
Daniele Andreini,
Erika Bertella,
Sarah Cortinovis,
Saima Mushtaq,
Claudia Foti,
Andrea Annoni, Alberto Formenti,
Andrea Baggiano,
Edoardo Conte,
Giovanni Ballerini,
Cesare Fiorentini,
Antonio L Bartorelli,
Mauro Pepi
[show abstract]
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ABSTRACT: BACKGROUND: The aims of this study are to evaluate the accuracy of low dose multidetector computed tomography coronary angiography (MDCT) versus invasive coronary angiography (ICA) in ruling out CAD in patients with mitral valve prolapse and severe mitral regurgitation (MVP) before cardiac surgery and to compare the overall effective radiation dose (ED) and cost of a diagnostic approach in which conventional ICA should be performed only in patients with significant CAD as detected by MDCT. METHODS: Eighty patients with MVP and without history of CAD were randomized to MDCT (Group 1) or ICA (Group 2) to rule out CAD before surgery. However, ICA was also performed as gold standard reference in Group 1 to test the diagnostic accuracy of MDCT. A diagnostic work-up A in whom all patients underwent low-dose MDCT as initial diagnostic test and those with positive findings were referred for ICA was compared with work-up B in which all patients were referred for ICA according to the standard of care in terms of ED and cost. RESULTS: The two groups were homogeneous in terms of gender, age and body mass index. The overall feasibility and accuracy in a patient-based model were 99% and 93%, respectively. The overall ED and costs were significantly lower in diagnostic work-up A compared to diagnostic work-up B. CONCLUSIONS: The accuracy of low dose MDCT for ruling out the presence of significant CAD in patients undergoing elective valve surgery for mitral valve prolapse is excellent with a reduction of overall radiation dose exposure and costs.
International journal of cardiology 09/2012; · 7.08 Impact Factor
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Daniele Andreini,
Gianluca Pontone,
Saima Mushtaq,
Antonio L Bartorelli,
Erika Bertella,
Laura Antonioli, Alberto Formenti,
Sarah Cortinovis,
Fabrizio Veglia,
Andrea Annoni,
Piergiuseppe Agostoni,
Piero Montorsi,
Giovanni Ballerini,
Cesare Fiorentini,
Mauro Pepi
[show abstract]
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ABSTRACT: The aim of this study was to assess the long-term prognostic role of multidetector computed tomography coronary angiography (CTA) in patients with suspected coronary artery disease (CAD).
Use of CTA is increasing in patients with suspected CAD. Although there is a large body of data supporting the prognostic role of CTA for major adverse cardiac events in the intermediate term, its long-term prognostic role in patients with suspected CAD is not well studied.
Between February 2005 and March 2008, 1,304 consecutive patients were prospectively studied with CTA for detecting the presence and assessing extent of CAD (disease extension and coronary plaque scores). Patients were classified according to the presence of normal coronaries and nonobstructive (<50%) and obstructive (>50%) coronary lesions. The composite rates of hard cardiac events (cardiac deaths and nonfatal myocardial infarctions) and all cardiac events (including late revascularization) were the endpoints of the study.
Seventy patients were excluded because their CTA data were uninterpretable. Of the remaining 1,234 patients, clinical follow-up (mean 52 ± 22 months) was obtained for 1,196 (97%). A total of 475 events were recorded, with 136 hard events (18 cardiac deaths and 118 nonfatal myocardial infarctions) and 123 late revascularizations. A total of 216 patients with early elective revascularizations were excluded from the survival analysis. Significant independent predictors of events in multivariate analysis were multivessel disease and left main CAD. Cumulative event-free survival was 100% for hard and all events in patients with normal coronary arteries, 88% for hard events and 72% for all events in patients with nonobstructive CAD, and 54% for hard events and 31% for all events in patients with obstructive CAD. Multivessel CAD was associated with a higher rate of hard cardiac events.
CTA provides prognostic information in patients with suspected CAD and unknown cardiac disease, showing excellent long-term prognosis when there is no evidence of atherosclerosis and allowing risk stratification when CAD is present.
JACC. Cardiovascular imaging 07/2012; 5(7):690-701. · 14.29 Impact Factor
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Gianluca Pontone,
Daniele Andreini,
Antonio L Bartorelli,
Erika Bertella,
Saima Mushtaq,
Andrea Annoni, Alberto Formenti,
Luisa Chiappa,
Sarah Cortinovis,
Andrea Baggiano,
Edoardo Conte,
Francesca Bovis,
Fabrizio Veglia,
Claudia Foti,
Giovanni Ballerini,
Cesare Fiorentini,
Mauro Pepi
[show abstract]
[hide abstract]
ABSTRACT: We conducted a meta-analysis evaluating the critical ratio between effective radiation dose (ED), feasibility (Fe) and diagnostic accuracy (Ac) of multidetector computed tomography (MDCT) for the detection of significant coronary artery disease. By using our predetermined criteria, we selected human studies published in English in which the ED and raw data of Ac vs. invasive coronary angiography in a segment based model were specified. Data from 31 studies including 3661 patients (mean age 61.9±4.5years, heart rate 62.5±6.7bpm) and 50,236 coronary artery segments were analysed and are reported. Overall, Fe, sensitivity, specificity, negative predictive value, positive predictive value, Ac and ED were 95%, 90%, 96%, 99%, 69%, 95% and 10.4±5.4mSv, respectively. Multivariate analysis showed that prospective ECG-gating (-8.8mSv CI95% -13.4 to -4.3mSv, p=0.001), dual-source (-3.7mSv CI95% -7.9 to 0mSv, p=0.05) and BMI-adapted scanning protocols (-4.5mSv CI95% -8.7 to -2.7mSv, p=0.03) were independent predictors of ED reduction. In patients with low heart rate, the best compromise between ED, Fe and Ac (2.5mSv, 97% and 98%, respectively) was obtained combining prospective ECG-gating and BMI-adapted scanning protocols, while in patients with high heart rate the strategy associated with the best results (10mSv, 98% and 97%, respectively) was the use of dual-source MDCT with retrospective ECG gating and modulation dose. In conclusion, careful selection of CT scanning protocols according to the patient's characteristics is critical for keeping the radiation exposure "as low as reasonably achievable" (ALARA) without impairing Fe and Ac.
International journal of cardiology 10/2011; 160(3):155-64. · 7.08 Impact Factor
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Michela Casella,
Francesco Perna,
Gianluca Pontone,
Antonio Dello Russo,
Daniele Andreini,
Gemma Pelargonio,
Stefania Riva,
Gaetano Fassini,
Mauro Pepi,
Giovanni Ballerini,
Massimo Moltrasio,
Benedetta Majocchi,
Stefano Bartoletti, Alberto Formenti,
Pasquale Santangeli,
Luigi Di Biase,
Andrea Natale,
Claudio Tondo
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ABSTRACT: Chest computed tomography (CT) scanning is increasingly used as an imaging technique in patients undergoing atrial fibrillation (AF) catheter ablation. Chest CT scans visualize organs other than the heart and collateral findings may be identified incidentally. Our study aims to assess the prevalence and clinical relevance of such collateral findings in patients undergoing AF ablation.
One hundred and seventy-three patients (127 males, age 59 ± 10 years) underwent chest CT scan for image integration in AF ablation. Collateral findings from visualized thoracic and upper abdominal organs were collected. Findings that required further investigations or treatment according to current guidelines were considered as clinically significant. A total of 164 collateral findings were identified in 97 (56%) patients, and most patients showed abnormalities of the lungs (67 patients, 39%). Forty-nine (28%) patients had clinically significant findings needing further investigation and 17 (10%) of them required specific treatments, including three cases (1.7 %) of lung malignancy.
Chest CT images acquired for integration in AF ablation should be read thoroughly as they may serve as a screening tool for otherwise unrecognized clinically significant conditions of the heart, lungs, or other visualized organs.
Europace 09/2011; 14(2):209-16. · 1.98 Impact Factor
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International journal of cardiology 08/2011; 152(2):251-4. · 7.08 Impact Factor
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Gianluca Pontone,
Daniele Andreini,
Antonio L Bartorelli,
Andrea Annoni,
Saima Mushtaq,
Erika Bertella, Alberto Formenti,
Sarah Cortinovis,
Francesco Alamanni,
Melissa Fusari,
Veronica Bona,
Gloria Tamborini,
Manuela Muratori,
Giovanni Ballerini,
Cesare Fiorentini,
Paolo Biglioli,
Mauro Pepi
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[hide abstract]
ABSTRACT: The aim of this study was to assess the accuracy of a comprehensive multidetector computed tomography (MDCT) evaluation of the aortic annulus (AoA), coronary artery disease (CAD), and peripheral vessels in patients referred for transcatheter aortic valve implantation (TAVI).
In 60 patients referred for TAVI, the following parameters were assessed with 64-slices MDCT and compared with transesophageal echocardiography (TEE), invasive coronary angiography (ICA), and peripheral angiography: AoA maximum diameter (Max-AoA-D(MDCT)), minimum diameter (Min-AoA-D(MDCT)), and area; lumen morphology index ([Max-AoA-D(MDCT)/Min-AoA-D(MDCT)]); length of the left, right, and non-coronary aortic leaflets; degree (grades 1-4) of aortic leaflet calcifications; distance between AoA and left main coronary ostium and between AoA and right coronary ostium CAD and peripheral vessel disease.
The Max-AoA-D(MDCT) and Min-AoA-D(MDCT) were 25.1 ± 2.8 and 21.2 ± 2.2 mm, respectively, with high correlation versus AoA diameter measured with TEE (r = 0.82 and 0.86, respectively). The area of AoA, systolic and diastolic lumen morphology index were 410 ± 81.5 mm(2), 1.19 ± 0.1 and 1.22 ± 0.11, respectively. Aortic leaflet calcification score was 3.3 ± 0.5. The lengths of left, right, and non-coronary aortic leaflets were 14.2 ± 2.4, 13.7.1 ± 2.1, and 14.5 ± 2.6 mm, whereas distances between AoA and the left main coronary ostium and between AoA, and the right coronary ostium were 13.7 ± 2.9 and 15.8 ± 3.5 mm, respectively. Feasibility, negative predictive value, and accuracy for CAD detection versus ICA were 87%, 100% (CI 100-100), and 96% (95% CI 94-100), respectively. All patients (N = 17) who were ineligible for TAVI were correctly detected by MDCT.
A comprehensive MDCT evaluation of patients referred for TAVI is feasible, provides more accurate assessment than TEE of AoA morphology, and may replace peripheral angiography in all patients and ICA in patients without significant CAD.
American heart journal 06/2011; 161(6):1106-13. · 4.65 Impact Factor
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ABSTRACT: This report describes the case of previous type-A aortic dissection treated with the placement of a termino-terminal prosthesis, which developed a large peri-prosthetic pseudoaneurysmatic sac, detected by CT, performed 2 years after the surgery. This raised the suspicion of a communication between the pseudoaneurysmatic sac and the aortic lumen, but was not able to show it directly. Transthoracic echocardiography confirmed the presence of the fistula, showing a systo-diastolic color Doppler jet signal connecting these two structures.The complementary role of these two diagnostic techniques allowed a complete evaluation of this complex pathology.
Journal of Cardiovascular Medicine 03/2011; 12(3):173-5. · 1.51 Impact Factor
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Daniele Andreini,
Gianluca Pontone,
Antonio L Bartorelli,
Saima Mushtaq,
Daniela Trabattoni,
Erika Bertella,
Sarah Cortinovis,
Andrea Annoni, Alberto Formenti,
Giovanni Ballerini,
Piergiuseppe Agostoni,
Cesare Fiorentini,
Mauro Pepi
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ABSTRACT: The accuracy of computed tomography (CT) for assessment of coronary stents is as yet unproven and radiation exposure has been a concern. The aim of our study is to compare radiation dose and diagnostic performance of CT with prospective ECG-triggering versus retrospective ECG-triggering for the detection of in-stent restenosis (ISR).
We enrolled 168 consecutive patients with suspected ISR, 83 studied using CT with prospective ECG-triggering (group 1) and 85 using retrospective ECG-triggering (group 2).
Prevalence of ISR according to catheter angiography was 24% in both groups. The overall evaluability was similar (93% in group 1 vs 95% in group 2). Artefact sub-analysis showed a significantly lower number of blooming and higher number of slice misalignment in group 1 vs group 2. In the stent-based analysis using only evaluable stents, specificity, positive predictive value and accuracy were significantly higher in group 1 (100%, 100% and 99%, respectively) than in group 2 (97%, 91% and 95%, respectively, p < 0.05). Group 1 was exposed to a lower radiation dose compared with group 2 (4.3 ± 1.4 mSv vs 18.5 ± 5.5 mSv, p < 00.1).
CT with prospective ECG-triggering can improve diagnostic accuracy of non-invasive imaging of coronary stents with a significant reduction in radiation exposure.
European Radiology 02/2011; 21(7):1430-8. · 3.22 Impact Factor
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Gianluca Pontone,
Daniele Andreini,
Antonio L Bartorelli,
Erika Bertella,
Saima Mushtaq,
Sarah Cortinovis,
Luisa Chiappa,
Andrea Annoni, Alberto Formenti,
Daniela Trabattoni,
Piero Montorsi,
Giovanni Ballerini,
Cesare Fiorentini,
Mauro Pepi
International journal of cardiology 01/2011; 147(3):454-7. · 7.08 Impact Factor
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Daniele Andreini,
Gianluca Pontone,
Saima Mushtaq,
Andrea Annoni, Alberto Formenti,
Erika Bertella,
Alessandro Parolari,
Piergiuseppe Agostoni,
Antonio Bartorelli,
Giovanni Ballerini,
Cesare Fiorentini,
Mauro Pepi
[show abstract]
[hide abstract]
ABSTRACT: Multidetector computed tomography (MDCT) is useful in evaluation of coronary artery bypass graft (CABG). However, radiation exposure is a reason for concern. We compared diagnostic performance and effective dose of a new dedicated post-processing reconstruction algorithm with BMI-adapted scanning protocol (MDCT-XTe) vs. standard prospective ECG-triggering protocol (MDCT-XT) and retrospective ECG-triggering (MDCT-Helical), compared to invasive coronary angiography (ICA), in the assessment of grafts and nongrafted or distal runoff coronary arteries.
One hundred and nineteen patients with 277 grafts were randomized to Group 1 based on BMI-adapted scanning protocol with prospective ECG-triggering (40 patients), Group 2 with prospective ECG-triggering (39 patients) and Group 3 (40 patients) with retrospective ECG-triggering. Data were acquired using 64-slice MDCT.
MDCT correctly assessed the patency of all CABG in 3 groups. After comparison with ICA, MDCT was able to correctly detect the occlusion or stenosis of CABG in all groups, with the exception of one case of Group 3. In Group 3 sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CABG evaluation were 100%, 98.4%, 96.7%, 100% and 98.9%, respectively. In Groups 1 and 2 the diagnostic accuracy of CABG evaluation was 100%. Effective radiation dose was 3.5±1.4mSv in Group 1 vs. 7.4±2.6mSv in Group 2 vs. 27.8±9.4mSv in Group 3.
Our results indicated that MDCT-XTe and MDCT-XT have a diagnostic performance in the evaluation of CABG similar to MDCT-Helical, with a significant reduction of radiation exposure, specially for MDCT-XTe.
International journal of cardiology 12/2010; 157(1):63-9. · 7.08 Impact Factor
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European Radiology 09/2010; 20(9):2200-1; author reply 2202-3. · 3.22 Impact Factor
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Daniele Andreini,
Saima Mushtaq,
Gianluca Pontone,
Sarah Cortinovis,
Andrea Annoni, Alberto Formenti,
Piergiuseppe Agostoni,
Antonio L Bartorelli,
Cesare Fiorentini,
Giovanni Ballerini,
Mauro Pepi
[show abstract]
[hide abstract]
ABSTRACT: It is unknown whether multidetector computed tomography (MDCT) has an additional clinical value compared to invasive coronary angiography (ICA) in the characterization of congenital coronary artery anomalies (CAA). We studied 2757 consecutive patients with 64-slice MDCT and classified CAA according to anatomical criteria and pathophysiology-clinical relevance. The prevalence of anatomical variants was: left dominance circulation (8%), absence of left main artery (1.3%), presence of intermediate ramus (22.6%), origin of conus branch from aorta (10.6%) and of the sinus node branch from the left circumflex coronary artery (15.3%). Among 380 CAA (13.8 %) detected with MDCT, 322 (85%) were an occasional finding. In the remaining 58 patients, MDCT performed after ICA confirmed CAA in 40 (69%) cases and detected or provided additional and more detailed informations in 18 (31%). Of these 18 patients, 14 showed malignant CAA. MDCT is the ideal method for the evaluation of CAA, not only allowing a precise anatomic visualization of coronary tree, but also adding important details in malignant congenital anomalies.
International journal of cardiology 03/2010; 145(2):388-90. · 7.08 Impact Factor
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Gianluca Pontone,
Daniele Andreini,
Antonio L Bartorelli,
Sarah Cortinovis,
Saima Mushtaq,
Erika Bertella,
Andrea Annoni, Alberto Formenti,
Enrica Nobili,
Daniela Trabattoni,
Piero Montorsi,
Giovanni Ballerini,
Piergiuseppe Agostoni,
Mauro Pepi
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to compare the diagnostic performance of multidetector computed tomography (MDCT) with prospective electrocardiogram (ECG) triggering versus retrospective ECG triggering.
MDCT allows the noninvasive visualization of the coronary arteries. However, radiation exposure is a reason for concern.
One hundred eighty consecutive patients scheduled for invasive coronary angiography were enrolled in this study. Twenty patients were excluded due to contraindications to sustain MDCT. Of the 160 remaining patients, 80 were studied with MDCT with prospective ECG triggering (Group 1) and 80 with a retrospective ECG triggering (Group 2). The individual radiation dose exposure was estimated.
In nonstented segments, the evaluability of Groups 1 and 2 was 96% versus 97%, respectively (p = 0.05), the accuracy in segment-based model was 93% versus 96%, respectively (p < 0.05) including diagnostic segments and 91% versus 94%, respectively (p < 0.01) including all segments, whereas the accuracy in a patient-based model was 98% in both groups. In stented segments the evaluability in Groups 1 and 2 was 92% versus 94%, respectively, and the accuracy was 93% versus 92%, respectively, including diagnostic stented segments and 90% versus 89%, respectively, including all stented segments. Group 1 presented lower radiation dose compared with Group 2 (5.7 +/- 1.5 mSv vs. 20.5 +/- 4.3 mSv, p < 0.01).
Prospective ECG-triggering computed tomography allows an accurate detection of coronary stenosis, despite a slight reduction of diagnostic performance, with a low radiation dose.
Journal of the American College of Cardiology 07/2009; 54(4):346-55. · 14.16 Impact Factor
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Daniele Andreini,
Gianluca Pontone,
Antonio L Bartorelli,
Daniela Trabattoni,
Saima Mushtaq,
Erika Bertella,
Andrea Annoni, Alberto Formenti,
Sarah Cortinovis,
Piero Montorsi,
Fabrizio Veglia,
Giovanni Ballerini,
Mauro Pepi
[show abstract]
[hide abstract]
ABSTRACT: Noninvasive assessment of coronary in-stent restenosis (ISR) is clinically useful but 4- and 16-slice multidetector computed tomography is limited due to stent strut artifacts. We evaluated the feasibility and accuracy of 64-slice multidetector computed tomography in the diagnosis of ISR to validate its accuracy in ISR quantification and identify factors that may affect stent patency evaluability. One hundred patients with previously implanted coronary stents (n = 179) underwent 64-slice multidetector computed tomography followed by invasive coronary angiography. After multidetector computed tomography, each stent was classified as "evaluable" or "unevaluable." Obstructive ISR was visually and quantitatively determined in evaluable stents. Correlations between quantitative multidetector computed tomography and quantitative coronary angiography were estimated. In a subgroup, multidetector computed tomographic and intravascular ultrasound measurements were correlated. Feasibility of stent visualization was 95%. Thirty-four of 39 ISRs (87%) were correctly detected and localized by multidetector computed tomography. ISR was correctly ruled out for 77% (128 of 131) of remaining stented lesions. Sensitivity, specificity, and positive and negative predictive values of multidetector computed tomography for ISR identification were 87%, 98%, 92%, and 96%, respectively. There was good correlation between percent stenosis evaluated by multidetector computed tomography versus quantitative coronary angiography and intravascular ultrasound (r = 0.794, p <0.001, and r = 0.943, p <0.0001, respectively) and good reproducibility of multidetector computed tomographic measurements (interobserver coefficient k 0.81 for diameter and 0.79 for area). Heart rate, complexity of stenting procedure, stent diameter, and strut thickness were factors limiting feasibility and accuracy. In conclusion, 64-slice multidetector computed tomography provides reliable and reproducible noninvasive evaluation of coronary stent patency and quantification of ISR.
The American journal of cardiology 06/2009; 103(10):1349-58. · 3.58 Impact Factor
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Gianluca Pontone,
Daniele Andreini,
Sarah Cortinovis,
Saima Mushtaq,
Erika Bertella,
Andrea Annoni, Alberto Formenti,
Francesco Giraldi,
Paolo Della Bella,
Giovanni Ballerini,
Piergiuseppe Agostoni,
Mauro Pepi
[show abstract]
[hide abstract]
ABSTRACT: It is unknown whether dilated cardiomyopathy (DCM) etiology influences cardiac veins (CVs) anatomy. By multidetector computed tomography (MDCT) we studied CVs of 93 patients with normal cardiac function (Group1) and of 99 DCM patients. In the latter we used a standard scanning coronary artery protocol (Group2, n=62) or a protocol specifically tailored to assess CVs in DCM (Group3, n=37). We also performed in all patients invasive coronary angiography. Group 1 had more CVs (83%) vs. DCM patients (72% and 76% in Groups 2 and 3 respectively, p<0.05). Group 2 had a higher percentage of CVs with insufficient imaging quality score (43 out of 224 veins, 19%) vs. Group 1 (6%, p<0.01) and Group 3 (11%, p<0.05) mainly due to low signal/noise ratio (32 out of 43 veins, 74%). Ischemic DCM patients had a lower CVs number (86/135, 64%) vs. both Group 1 patients and vs. non-ischemic DCM. Therefore MDCT is feasible for assessing CVs in DCM using scanning CVs tailored protocols. Ischemic DCM patients have a lower number of CVs compared to normal systolic function or non-ischemic DCM patients.
International journal of cardiology 04/2009; 144(2):340-3. · 7.08 Impact Factor
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ABSTRACT: We describe the clinical case of a thymoma, surgically removed after diagnosis, staging, and preoperative assessment performed by means of cardiac electrocardiogram-gated multidetector computed tomography. This technique allowed a very accurate assessment of the mass, proving superior to conventional computed tomography thanks to the possibility of identifying the relationships of the mass with the mediastinal structures, including the large vessels and coronary arteries. It also established the origin of the arterial vascularization from a tributary branch of the left internal mammary artery, visualizing the pathway and the relationship of the vessel with the mass and the point where it is penetrated. Finally, we analyzed the anatomy and patency of the coronary arteries, essential data in this patient with a high risk of coronary artery disease.
Journal of thoracic imaging 03/2009; 24(1):31-3. · 1.42 Impact Factor
