Key result
Preoperative chest CT alters surgical strategy in ~9% of high-risk cardiac surgery patients.
Why the study?
Arteriosclerosis of the ascending aorta is increasingly encountered in cardiac surgical patients, and the impact of preoperative Chest CAT scan on surgical strategy needed evaluation.
Does introducing preoperative Chest CAT scan change surgical strategy in cardiac surgical patients?
Observational (n=195)
No
Does introducing preoperative Chest CAT scan change surgical strategy in cardiac surgical patients?
Evaluates the impact of preoperative chest CAT scans on surgical strategy in cardiac surgical patients with potential ascending aortic arteriosclerosis.
May support selective preoperative CT in high-risk patients; hypothesis-generating for outcomes, requiring prospective confirmation.
Introduction: Arteriosclerosis of the ascending aorta is increasingly encountered in cardiac surgical patients as patients accepted for cardiac surgery get older.We evaluated the effect of introducing preoperative Chest CAT scan in the preoperative work-up for cardiac surgery concerning the change in strategy. Materials and methods:From May 1st 2015 until October 1st 2015 all patients of 70 years and older as well as younger patients with peripheral vascular disease presented in the heart team and accepted for surgery received a preoperative Chest CAT scan.We evaluated in which patients the initially established treatment was changed.Furthermore we investigated which patients had a stroke after surgery.Results: 583 patients were discussed in the Heart Team during the study period.290 patients were accepted for surgery.195 patients fitted the criteria for a CAT scan.In this group in 18 patients (9.2%) the treatment was changed because of severe calcification of the ascending aorta or peripheral cannulation site.None of the 272 patients who underwent surgery had a stroke.Conclusion: Preoperative Chest Cat scan gives essential information concerning the calcification of the ascending aorta and should be recommended in the preoperative work-up at least in elderly patients and patients with peripheral vascular disease.
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Dikhoff et al. (2017) conducted an observational in Cardiac surgical patients (n=195). Preoperative Chest CAT scan was evaluated on Change in established treatment strategy due to severe calcification. Preoperative chest CAT scanning led to a change in the planned surgical strategy in 9.2% of high-risk cardiac surgery patients due to severe calcification of the ascending aorta or cannulation site.
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