A 22-year-old male presented to the cardiothoracic surgery department with 1-week of hemoptysis, with worsening for 1-day, accompanied by cough, chest tightness, and dizziness. He reported a history of occasional palpitations after fatigue. Physical examination revealed cyanosis and clubbing fingers (Fig. 1A). The oxygen saturation was 75.2 % and the hematocrit was 0.724L/L. Non-contrast chest CT showed mixed ground-glass opacity in the right upper lobe, suggesting inflammation (Fig. 1B). The e…
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Geographical distribution and accessibility to cardiac CT readers in the United States: A snapshot from the 2022 medicare analysis
Cardiac computed tomography (CCT) is an increasingly important modality for the diagnosis and management of cardiovascular diseases. However, disparities in the availability of trained CCT readers across the United States limit equal access.
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Incremental prognostic value of aortic tortuosity index in older patients undergoing transcatheter aortic valve replacement
In older patients, the complex interplay between muscle deterioration, cognitive decline, and vascular dysfunction represents a crucial triad of health challenges associated with aging.1 Despite its known associations, the incremental prognostic value of vascular impairment in older patients with low muscle mass areas (MMAs) remains unclear. This study aimed to evaluate whether the aortic tortuosity index (ATI) provides incremental prognostic value over muscle mass areas (MMAs) for predicting ad…
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Is coronary computed tomography angiography the ideal modality for assessing the interplay between coronary physiology and plaque pathobiology
Intravascular imaging-based coronary artery modelling is today considered as the optimal approach to assess plaque morphology and examine the effect of the local hemodynamic forces on plaque progression.1 The high-fidelity models reconstructed from intravascular imaging data enable accurate evaluation of the wall shear stress (WSS) distribution, characterization of plaque phenotypes and assessment of the changes in plaque composition. However, invasive imaging has also significant limitations as…
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First use of CT pulmonary angiography and fluoroscopy fusion during thrombectomy in acute pulmonary embolism
The use of percutaneous interventions for acute pulmonary embolism (PE) is steadily increasing, particularly in patients who are not candidates for systemic thrombolysis. Traditionally, pulmonary vascular anatomy—including anatomical variants, vessel size, branch bifurcations, and thrombus location—is assessed using contrast-enhanced angiography to guide mechanical thrombectomy. However, this conventional strategy is associated with several risks, including allergic reactions due to repeated con…
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Validation of physiological principles of Non-Invasive fractional flow reserve derived from CT coronary angiography
Coronary computed tomography angiography (CTA) simulation of fractional flow reserve (FFR) is derived from allometric and morphometric scaling principles, allowing inference of physiological parameters from anatomical measures like left-ventricular (LV) mass and coronary luminal dimensions. Validity of these assumptions in humans remains uncertain, with supporting data derived from animal models.
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Unveiling the silent echoes: Multiple sinus of valsalva aneurysms as a rare cardiac imprint of Takayasu arteritis depicted on CT angiography
Takayasu arteritis is a rare acquired cause of Sinus of Valsalva aneurysm (SVA) wherein adventitial and medial infiltration of inflammatory cells causes thinning of aortic wall with resultant bulging of thin walled aneurysms.1 The current case, in the setting of Takayasu arteritis, shows multiple unruptured SVAs with simultaneous involvement of right and left cusps of Sinus of Valsalva (SOV), a rare case presentation which to our best knowledge, has never been reported so far. A 34-year-old fema…
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Lumen-isodense coronary plaque – A challenge for coronary computed tomography (CTA), leading to inaccuracies in stenosis grading?
Coronary plaque with equal density to the coronary lumen (lumens-isodense) are frequent (12.7% prevalence) on coronary CTA. The discordance rate to invasive coronary angiography (ICA) is relatively high. Lumens isodense plaques should be reported to raise awareness for possible inaccuracies in stenosis grading.
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Impact of cardiac phase selection on computational fluid dynamics analysis
The selection of cardiac phase in coronary computed tomography angiography (CCTA) may affect computational fluid dynamics (CFD)-derived hemodynamic metrics; however, this influence is not well-quantified, particularly in anomalous coronary anatomies. This study aims to evaluate how cardiac phase selection impacts CFD outcomes in normal and anomalous coronary arteries.
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Roadmap analysis for coronary artery stenosis detection and percutaneous coronary intervention prediction in cardiac CT for transcatheter aortic valve replacement
The new artificial intelligence-based software, Roadmap (HeartFlow), may assist in evaluating coronary artery stenosis during cardiac computed tomography (CT) for transcatheter aortic valve replacement (TAVR).