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Vol. 55. Issue 1.
Pages 24-36 (January - February 2013)
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Vol. 55. Issue 1.
Pages 24-36 (January - February 2013)
Update in Radiology
Cardiac computed tomography for valve disease
La tomografía computarizada cardiaca en la afección valvular
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5227
H. Cuéllara,
Corresponding author
hugcuellar@yahoo.es

Corresponding author.
, A. Roquea, V. Pinedaa, J. Rodríguezb
a Instituto de Diagnóstico por la Imagen (IDI), Servicio de Radiología, Hospital de la Vall d’Hebron, Barcelona, Spain
b Laboratorio de Ecocardiografía, Servicio de Cardiología, Hospital de la Vall d’Hebron, Barcelona, Spain
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Tables (3)
Table 1. Etiology of left valvular diseases according to the Euro Heart Survey.
Table 2. Indicative table of the optimal phases of the cardiac cycle to visualize the coronary arteries and left valves, expressed as relative percentages of the R–R interval.
Table 3. Comparison of results reported by the main studies on non-invasive coronary angiography with CCT in patients with valvular disease.
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Abstract

Heart valve disease and coronary heart disease are very prevalent in the general population and often coincide in the same patient. Cardiac computed tomography (CT) makes it possible to noninvasively rule out coronary disease before valve surgery and to potentially avoid invasive heart catheterization in 66–75% of patients. The same imaging test provides abundant anatomic and functional information that complements the information from echocardiography, making it possible to characterize the etiology of the valve disease and its repercussions on the heart and aorta, as well as to quantify the severity of disease affecting the valves of the left side of the heart.

In this article, we describe the anatomy of the heart valves and the technical requisites of cardiac CT for the study of the valves. We go on to explore the usefulness of CT in the preoperative study of the coronary arteries and in the morphological and functional characterization of valve disease, with special emphasize on the valves of the left side of the heart.

Keywords:
Volumetric computed tomography
Coronary heart disease
Angiography
Heart valve disease
Resumen

La patología valvular cardiaca y la enfermedad coronaria son muy prevalentes en la población general y frecuentemente coinciden en el mismo paciente. La TC cardiaca permite descartar la enfermedad coronaria antes de la cirugía valvular de forma no invasiva y evitar potencialmente un 66-75% de las coronariografías invasivas. La misma prueba aporta abundante información anatómica y funcional complementaria a la ecocardiografía, que permite caracterizar la etiología de las valvulopatías, así como su repercusión en el corazón y la aorta y, en el caso de las válvulas izquierdas, cuantificar su gravedad.

En este trabajo se describe la anatomía valvular cardiaca y los requisitos técnicos de la TC cardiaca para el estudio valvular, para profundizar posteriormente en el valor de la coronariografía prequirúrgica y la caracterización morfo-funcional de la patología valvular mediante TC, haciendo hincapié en las válvulas izquierdas.

Palabras clave:
Tomografía computarizada volumétrica
Enfermedad cardiaca coronaria
Arteriografía
Enfermedades de las válvulas cardiacas

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