We read with great interest the recent article by Bhatia et al., “Coronary CT angiography versus invasive angiography for preoperative coronary assessment prior to valve surgery,” which provides a systematic review and meta-analysis addressing the diagnostic and perioperative outcomes of a CCTA-first strategy.1 The authors conclude that CCTA may effectively reduce the need for ICA without compromising patient safety. While these findings are encouraging, we believe that several aspects of the an…