Application of Computed Tomography Angiography in Evaluation of Coronary Heart Disease Before Aortic Valve Replacement / 中国微创外科杂志

ABSTRACT

Objective To discuss the accuracy of computed tomography angiography(CTA)in the diagnosis of coronary heart disease before aortic valve replacement(AVR). Methods A total of 150 elderly aortic valve disease patients from January 2011 to December 2015 were investigated.The ECG showed ST-T changes.All the patients underwent coronary angiography(CAG) and CTA pre-operation.With the results of CAG as a golden standard, the sensitivity, specificity, positive predictive value and negative predictive value of CTA were analyzed. Results In patients with more than 50% stenosis, the sensitivity, specificity, positive predictive value,and negative predictive value were 97.4%(115/118),87.5%(28/32),96.6%(115/119), and 90.3%(28/31),respectively.According to the number of involved coronary artery,the sensitivity,specificity,positive predictive value,and negative predictive value were 97.4%(115/118),87.5%(28/32),96.6%(115/119), and 90.3%(28/31), respectively.In patients with more than 75% stenosis, the sensitivity, specificity, positive predictive value, and negative predictive value were 100.0%(52/52),67.3%(66/98),61.9%(52/84),and 100.0%(66/66),respectively.According to the number of involved coronary artery,the sensitivity,specificity,positive predictive value,and negative predictive value were 98.2%(166/169),64.3%(277/431),51.9%(166/320), and 98.9%(277/280), respectively. Conclusion Coronary CTA can be reliably used for screening before AVR.For patients with negative findings by CTA,CAG is not necessary.