RESUMO
PURPOSE: The present study evaluates clinical feasibility of cardiac multidetector computed tomography angiography (MDCTA) to detect significant stenosis of coronary vessels due to transplant vasculopathy (TVP) after heart transplantation (HTx). METHODS: Twenty-eight consecutive male HTx-recipients scheduled for their annual routine conventional coronary angiography (CCA) additionally underwent 64-slice MDCTA. RESULTS: Two patients were excluded from further MDCTA analysis. Out of 371 remaining coronary vessel segments evaluable by CCA, MDCTA was able to depict 302 (81.4%) in diagnostic image quality. On a segment based analysis, sensitivity, specificity, diagnostic accuracy (DA), negative predictive value (NPV), and positive predictive value (PPV) for detection of significant stenosis were calculated with 87.5%, 97.3%, 97.0%, 99.7%, and 46.7%, respectively. On a patient-based evaluation, sensitivity, specificity, DA, NPV, PPV were 100%, 81%, 84.6%, 100% and 55.6%, respectively. Evaluation of stenosis degree by MDCTA showed systematic overestimation of 4.4%. A moderate to good agreement comparing both modalities was found (Pearson's correlation coefficient: 0.64). CONCLUSION: High NPV suggesting 64-slice MDCTA being a reliable diagnostic tool for ruling out significant stenosis due to TVP in HTx patients. But its clinical value in these particular patients needs further investigation.
