A 76-year-old woman with shortness of breath presented for a follow-up transthoracic echocardiography after transcatheter tricuspid valve replacement (TTVR) with 44 mm Evoque. After the procedure, the patient missed several weeks of her direct oral anticoagulant (DOAC), apixaban. Transthoracic echocardiography (TTE) showed a mean tricuspid valve gradient of 6 mmHg across the tricuspid valve. The patient was therefore sent for a cardiac computed tomography (CCT) to evaluate the tricuspid valve l…
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CT derived fractional flow reserve: Part 2 – Critical appraisal of the literature
The integration of computed tomography-derived fractional flow reserve (CT-FFR), utilizing computational fluid dynamics and artificial intelligence (AI) in routine coronary computed tomographic angiography (CCTA), presents a promising approach to enhance evaluations of functional lesion severity. Extensive evidence underscores the diagnostic accuracy, prognostic significance, and clinical relevance of CT-FFR, prompting recent clinical guidelines to recommend its combined use with CCTA for select…
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Prospective evaluation of computed tomography imaging for left atrial appendage exclusion using AtriClip: Impact on device sizing and imaging outcomes
AtriClip device (AtriCure Inc.) is a surgical device approved for left atrial appendage (LAA) exclusion and available in 4-sizes: 35-, 40-, 45- and 50-mm. Device size is determined during surgery by measuring the LAA length at the base with forceps or using the associated Selection Guide. In contrast, transcatheter LAA closure devices are sized solely on preprocedural imaging without operator dependency. Appropriate sizing is crucial, as inappropriate sizing may lead to incomplete exclusion or d…
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Quantitative computed tomography assessment of right ventricular remodeling after right ventricular outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect: Correlations with echocardiographic parameters
This retrospective study aimed to assess computed tomography (CT)-derived quantitative right ventricular (RV) remodeling patterns after RV outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect and correlate them with echocardiographic parameters.
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Prognostic value of plaque burden assessed by coronary CT angiography in known coronary artery disease
We aimed to investigate in patients with known coronary artery disease (CAD) whether plaque burden assessed by coronary computed tomography angiography (CCTA) can predict subsequent all-cause mortality (ACM).
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Comparative assessment of CAC and SIS plaque burden categories via AI-guided quantitative CT analysis
Extensive data demonstrate that coronary artery calcium (CAC) scoring powerfully stratifies cardiovascular risk beyond traditional risk factors.1 Budoff et al. showed in 25,253 asymptomatic individuals that adding CAC to risk models markedly improved prediction (C-index 0.61 to 0.81).1 CAC burden correlates with incident events in a graded manner: patients with CAC >400 have substantially higher rates of myocardial infarction and death compared to those with CAC = 0123. The segment involvemen…
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Triple-Vessel Coronary Cameral Fistula as a Cause of diffuse Coronary Artery Ectasia: Diagnostic Insights from Coronary CT Angiography
A 68-year-old female was investigated for a viral-like illness. Incidentally, an unenhanced chest computed tomography (CT) reported prominent “pericardial varicosities”. She had no cardiac history, was asymptomatic, and had a normal physical examination.
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Plaque quantification from coronary computed tomography angiography in predicting cardiovascular events: A systematic review and meta-analysis
Plaque volumes quantified from coronary computed tomography angiography (CCTA) may offer improved risk prediction for future major adverse cardiovascular events (MACE) above current standards of care. This systematic review and meta-analysis examines the association between CCTA-derived plaque volumes and future MACE in stable coronary artery disease (CAD).
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Anatomically indexed aortic valve calcium score more accurately predicts transaortic peak velocities and gradients compared to radiomics features in patients with severe aortic stenosis
This study examines the use of computed tomography (CT)-derived calcified and non-calcified aortic valve (AV) features, including radiomics-based quantitative imaging biomarkers, for predicting aortic stenosis (AS) severity and evaluating sex-specific differences.
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Right atrial-to-pulmonary vein fenestration causing partial unroofing of right superior pulmonary vein: Findings on virtual dissection
A 4-year-old acyanotic child presented with recurrent respiratory tract infections and exertional dyspnea. Transthoracic echocardiography demonstrated a large ostium secundum atrial septal defect (ASD) with deficient rims and left to right shunting across the defect. There was presence of severe valvular pulmonic stenosis with a transvalvular gradient of 70 mm of Hg. There was mild tricuspid regurgitation with normal biventricular functions. A suspicion of an associated partial anomalous pulmon…