Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients.

BACKGROUND: Scanxiety, the anxiety/stress associated with an imaging test, has never been evaluated in relation to coronary CT angiography (Coronary CTA). As it could impact heart rate and thereby affect image quality of Coronary CTA, we aimed to evaluate the prevalence, severity, and impact of scanxiety on quality and interpretability of Coronary CTA. METHODS: 366 consecutive patients were prospectively presented with a clinical questionnaire comprising two tests to evaluate their scan-related anxiety: the Impact of Event IES-6 (6 questions, final score 0-24) and a visual stress-scale (1 question, score 1-10). Patient demographics, heart rate and final image quality scored by two readers were recorded. Potential independent correlations were sought between IES-6 scanxiety level and image quality, heart rate variability and demographics, using an ordinal logistic regression model. RESULTS: 344 patients (59.9% men, 57.6 ±â€¯10.7yo) completed the questionnaire. 74.1% (255 patients) reported some scan-related distress, with a mean IES-6 score of 4.1 ±â€¯4.3 (range 0-18). There was no significant difference in terms of age, sex or indications for Coronary CTA between the non-anxious (IES-6 = 0) and the anxious (IES-6>0) patients. There was no significant independent correlation between image quality and IES-6 score (OR = 0.98, p = 0.62), nor between IES-6 score and heart rate variability (effect = -0.005, p = 0.97). CONCLUSION: The prevalence of scan-related anxiety - aka scanxiety - in Coronary CTA patients is high (74.1%) but does not appear to impact image quality and interpretability.

Imaging for structural heart procedures: focus on computed tomography.

The success and continued rapid clinical integration of transcatheter valve technologies relies on imaging modalities to guide safe and effective device deployment. In particular, cardiac imaging, using both echocardiography and CT, is an integral resource for the multidisciplinary team. These modalities can provide valuable insight for the proceduralist at each stage of transcatheter-based valve insertion, as they can be used reliably to define the anatomy of interest and its relationship to surrounding structures, determine accurate device sizing, assess patients for valve-in-valve procedures, and screen for adverse features or procedural contraindications. We provide an overview of some of the key aspects of the use of CT and echocardiography in the context of transcatheter aortic valve replacement (TAVR), as well as transcatheter mitral valve replacement (TMVR).

Computed tomography assessment for transcatheter aortic valve in valve implantation: The vancouver approach to predict anatomical risk for coronary obstruction and other considerations.

Valve-in-valve implantation of a transcatheter heart valve into a failed bioprosthetic heart valve has emerged as a treatment alternative to repeat conventional surgery. This requires careful pre-procedural assessment using non-invasive imaging to identify patients at risk for procedure related adverse events, such as ostial coronary occlusion. Herein we report how to comprehensively assess aortic root anatomy using computed tomography prior to transcatheter valve implantation for failed bioprosthetic aortic valves.