Coronary CTA for Surveillance of Cardiac Allograft Vasculopathy |
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| Authors: | Nishant R. Shah Ron Blankstein Todd Villines Hafiz Imran Alan R. Morrison Michael K. Cheezum |
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| Affiliation: | 1.Lifespan Cardiovascular Institute, Division of Cardiovascular Medicine, Dept. of Medicine,Brown University Alpert Medical School,Providence,USA;2.Dept. of Medicine (Cardiovascular Division) and Radiology, Brigham and Women’s Hospital,Harvard Medical School,Boston,USA;3.Dept. of Medicine, Cardiology Service,Walter Reed National Military Medical Center,Bethesda,USA;4.Dept. of Medicine, Cardiology Service,Fort Belvoir Community Hospital,Fairfax County,USA |
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| Abstract: | Purpose of ReviewThe purpose of this review is to highlight recent hardware and software advances in coronary computed tomography angiography (CTA) that make it a potentially viable alternative to invasive coronary angiography for surveillance of cardiac allograft vasculopathy (CAV) in heart transplant recipients.Recent FindingsDual-source CT, multisegment reconstruction, and intracycle motion correction algorithms are all technologies applied during or after image acquisition that can improve image quality and diagnostic accuracy in patients with elevated heart rates, such as heart transplant recipients. CT fractional flow reserve may also add value in this clinical scenario.SummaryCoronary CTA now has equivalent diagnostic accuracy, offers more nuanced anatomic information, is inherently safer, and could be less costly than invasive coronary angiography. For these reasons, coronary CTA may now be a viable alternative to ICA for CAV surveillance in heart transplant recipients. |
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