EBCT Best For Evaluating Adults With Congenital Defects In The Heart Arteries
- Date:
- August 17, 2005
- Source:
- Society for Cardiovascular Angiography and Interventions
- Summary:
- Electron-beam computed tomography (EBCT) is more accurate than conventional catheter angiography for identifying which adult patients face the greatest risk of sudden death from congenital abnormalities in the arteries supplying blood to the heart, according to a study in the September 2005 issue of Catheterization and Cardiovascular Interventions: Journal of the Society for Cardiovascular Angiography and Interventions.
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BETHESDA, MD -- Electron-beam computed tomography (EBCT) is moreaccurate than conventional catheter angiography for identifying whichadult patients face the greatest risk of sudden death from congenitalabnormalities in the arteries supplying blood to the heart, accordingto a study in the September 2005 issue of Catheterization andCardiovascular Interventions: Journal of the Society for CardiovascularAngiography and Interventions.
The study found that both EBCT and conventional x-ray angiography wereable to detect the abnormalities--for example, a left coronary arteryoriginating from the right side of the aorta, or vice versa--but EBCTtrumped angiography in more than one-third of cases when determiningwhether the artery traveled perilously between the aorta and pulmonaryartery, or followed a safer path around the two "great vessels."
An artery that passes between the aorta and pulmonary arterymakes a sharp bend at its origin. In addition, it can be squeezedbetween the great vessels as the heart beats. Under the rightconditions--such as strenuous athletic activity--blood flow through theartery may be blocked, causing a heart attack or even sudden death.
"The most crucial clinical question is whether the artery is coursingbetween the aorta and pulmonary artery. Angiography did not always giveus the correct answer, but it was very easy to tell using EBCT," saidDr. Esat Memisoglu, an assistant professor of radiology at St. LouisUniversity Hospital.
The study, which was conducted at a heart hospital and imagingcenter in Istanbul, Turkey, involved 28 adults who had had conventionalx-ray angiography for chest pain or shortness of breath and laterunderwent an EBCT study. In half of the patients, angiography showed acongenital abnormality in the coronary arteries. The other 14 patientsserved as a control group.
The radiologists who interpreted the EBCT studies were not informed ofthe results of the angiographic study. In 5 of 14 cases, EBCT disagreedwith angiography when characterizing the pathway the abnormal arteryfollowed between, or around, the great vessels. Later, joint review bythe cardiologist and radiologist concluded the EBCT findings to becorrect.
In addition to its greater accuracy, EBCT has other keyadvantages over conventional angiography. Dr. Memisoglu said. The scancan be completed in 30 seconds or less. It requires only an intravenousinjection of x-ray dye, rather than passage of a catheter from a groinartery into the heart. The radiation dose is low. Image detail is good.And, with the touch of a button, it is possible to produce stunningthree-dimensional images of the heart that can be viewed from anyangle. In addition, unlike some other noninvasive imaging methods, EBCTcaptures images so quickly it is not necessary to give the patientmedication to slow the heart rate. Together, these factors make EBCTthe best choice for examining patients suspected of having congenitalabnormalities of the coronary arteries.
"If you are looking to better evaluate a coronary anomaly, EBCT is the best overall imaging method," Dr. Memisoglu said.
Headquartered in Bethesda, Md., the Society for CardiovascularAngiography and Interventions is a 3,400-member professionalorganization representing invasive and interventional cardiologists.SCAI's mission is to promote excellence in invasive and interventionalcardiovascular medicine through physician education and representation,and advancement of quality standards to enhance patient care. SCAI wasorganized in 1976 under the guidance of Drs. F. Mason Sones and MelvinP. Judkins. The first SCAI Annual Scientific Sessions were held inChicago in 1978.
The Society for Cardiovascular Angiography and Interventionsprovides news reports of clinical studies published in Catheterizationand Cardiovascular Interventions: Journal of the Society forCardiovascular Angiography and Interventions (CCI) as a service tophysicians, the media, the public, and other interested parties.However, statements or opinions expressed in these reports reflect theview of the author(s) and do not represent official policy of SCAIunless so stated.
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