Coronary CTA in a Patient with Previous Allogenic Heart Transplantation and a Heart Rate of 102 bpm

SOMATOM Definition Cardiac Scanning

Johannes Rixe, MD; PD Thorsten Dill, MD
Department of Cardiology, Kerckhoff-Clinic, Bad Nauheim, Germany
 |  2007-08-14

History

A 66-year-old male patient who had undergone allogenic heart transplantation 16 years ago was referred to non-invasive coronary angiography for the exclusion of significant coronary artery stenoses.

 

Diagnosis
The mean heart rate during examination was 102 beats per minute (bpm), no administration of beta blockers was performed prior to the scan. After calculation of the contrast transit time using a test bolus approach, coronary CT-Angiography was performed in craniocaudal direction injecting 65 ml of iodine contrast agent followed by a 50 ml saline chaser, both at 5 ml/s. Due to the relatively high heart rate a pitch of 0.39 was chosen, resulting in scan time of 7 seconds.

A systolic reconstruction at 40 % of the RR-cycle provided the artifact-free visualization and allowed the exclusion of significant stenoses and plaque burden in the Left Artery Descending and the Ramus Circumflex. Even the Right Coronary Artery, which is frequently affected by motion artifacts at heart rates of more than 60 bpm, could be visualized in its entire course without artifacts.


Comments
In conclusion, this case confirms the ability of DSCT to visualize coronary artery lumina without motion artifacts independent from the patient‘s heart rate and without precedent heart rate lowering medication.

 

Fig. 1: Artefact-free VRT visualization of Left Artery Descending and Ramus Circumflex.
Fig. 2: Exclusion of significant stenoses and plaque burden in Left Artery Descending.
Fig. 3: Exclusion of significant stenoses and plaque burden in right coronary artery.
 

Examination Protocol

Scanner
SOMATOM Definition
Scan area
Heart
Scan length
140mm
Scan time
7s 
Scan direction
Cranio-caudal
kV
120kV
Rotation time
0.33 s
Slice collimation
0.6 mm
Reconstructed slice thickness                             
0.6 mm
Spatial Resolution                
0.33 mm
Contrast Amount
65 ml Enhance / 50 ml NaCl
Contrast Flow rate
5 ml/s

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Los fármacos y dosis mencionados en el presente son consistentes con la etiqueta de aprobación para usos y/o indicaciones del fármaco. El médico que lo trata es completamente responsable del diagnóstico y tratamiento de los pacientes, incluyendo los medicamentos y dosis prescritas en relación con dicho uso. Las instrucciones de funcionamiento se deben seguir con cuidado cuando se usa el sistema. El origen de los datos técnicos es correspondiente a las fichas técnicas. Los resultados pueden variar.