Comments on: Comparison of dual source computed tomography versus intravascular ultrasound for evaluation of coronary arteries at least one year after cardiac transplantation http://www.thepreparedminds.com/archives/480 In the field of observation, chance favors the prepared minds. Sat, 04 Feb 2012 14:45:45 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Jacobo Kirsch, MD http://www.thepreparedminds.com/archives/480/comment-page-1#comment-474 Jacobo Kirsch, MD Mon, 23 Nov 2009 15:26:38 +0000 http://www.thepreparedminds.com/?p=480#comment-474 Two things to keep in mind are: 1. Study was done using dual-source technology with a temporal resolution of a quarter-gantry rotation of 82 msec. This may be the most variable when assessing patients with difficulty in heart-rate control (due to denervation). 2. Coronary allograft vasculopathy affects the entire vessel and small branches which are commonly not well evaluated by CTA. Two things to keep in mind are:

1. Study was done using dual-source technology with a temporal resolution of a quarter-gantry rotation of 82 msec. This may be the most variable when assessing patients with difficulty in heart-rate control (due to denervation).

2. Coronary allograft vasculopathy affects the entire vessel and small branches which are commonly not well evaluated by CTA.

]]> By: Ronen Rubinshtein, MD http://www.thepreparedminds.com/archives/480/comment-page-1#comment-375 Ronen Rubinshtein, MD Sat, 07 Nov 2009 16:04:30 +0000 http://www.thepreparedminds.com/?p=480#comment-375 This publication, illustrates another promising non-invasive option for post transplant patients who undergo repeated invasive angiographies + IVUS during follow-up. Nonetheless, coronary allograft vasculopathy is a major concern after heart transplant and one should consider the relatively low risk associated with the gold standard (invasive angiogram + IVUS) in this specific group (at experienced centers) vs the option of CT angiography (with less than 100% NPV). If replicated, perhaps at least some of the angiograms during follow-up could be replaced by CTA (with a new generation, high resolution scanner). This publication, illustrates another promising non-invasive option for post transplant patients who undergo repeated invasive angiographies + IVUS during follow-up. Nonetheless, coronary allograft vasculopathy is a major concern after heart transplant and one should consider the relatively low risk associated with the gold standard (invasive angiogram + IVUS) in this specific group (at experienced centers) vs the option of CT angiography (with less than 100% NPV). If replicated, perhaps at least some of the angiograms during follow-up could be replaced by CTA (with a new generation, high resolution scanner).

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