Cardiac Cath vs. CT Angiogram?

[JaneBerm]

Is there anyone else here who has had a CT Angiogram (Computerized Axial Tomography Scan) INSTEAD of a cardiac catheterization? My cardiologist talked my surgeon into substituting this less invasive test and they were able to get very clear pictures from a procedure that took less than a half hour.

My results came back showing that there were no blockages that would require a bypass, but confirming that my aorta was boarderline at 3.9, causing my surgeon to change plans for a minimally invasive procedure to replace my severely stenoic bicuspid aortic valve (.65 cm 2).

My question is, "if this much easier test gives the same results, why isn't it being used more often?" Any ideas or discussion on this subject?

 

[skeptic49]

I was supposed to have both in December but I ended up only getting the CT Angio due to an office error. I don't really know whether just the CT is sufficient but the surgeon seemed to want it then. I guess it depends on the doctor. However, when I next go back I'm just supposed to get another CT, so that tells me that it's not a bad idea to ask if the more invasive procedure is really necessary.

Jim

 

[Lynlw]

I know one reason is the large amount of radiation, and for somethings caths get better info, I believe the pressure measurements are better in a cath, BUt I'm not sure why they aren't done more often. This site http://www.radiologyinfo.org/en/info.cfm?PG=angioct is from a radiology group and has this under limitations "
If a patient's heart is not functioning normally, or if there are multiple blocked blood vessels, CT angiograms may be hard to interpret. CT angiograms are not yet as reliable as selective catheter injections (performed after puncture of the artery in the groin) in imaging small tortuous arteries, particularly coronary arteries in the rapidly moving heart."

For yearly checkup Justin has a Cardiac MRI, but has caths pre op or if they hope to do something interventional to avoid surgery

 

[Adrienne]

I correspond with a woman in Texas (friend of a friend) who had a mitral valve repair. She had a CT angiogram to begin with and it showed some blockage in her arteries. Because of that, they had her have a cath to make sure, and the cath showed that the arteries were clear.

 

[westie]

one in a thousand

one in a thousand

.
a ct angiogram appealed greatly to me too, but the surgeon told me there is a one in a thousand chance of getting lung cancer from the massive radiation you are exposed to. and if the ct was inconclusive or blockages were found, then a conventional cath would still be required.

despite my dread of invasive proceedures, a ct angiogram seemed a lose, lose proposition

 

[Lynlw]

Here is a pretty interesting recent article about the amount of radiation http://www.msnbc.msn.com/id/29001294/ "CHICAGO - Patients are receiving the equivalent of 600 chest X-rays when they get CT scans for heart disease

 

[ottagal]

My cardiologist said that 'when the times comes' he is considering a CT rather than angiogram for me as it is a less invasive procedure and feels I am already considered low risk for having coronary artery disease.

Here is an intersting link comparing the 2 procedures:

http://www.ct-angiogram.com/Angiogram_vs._CT_Catscan_Angiogram_2273.htm

 

[catwoman]

Jane:

When John had his heart cath pre-op, we were told that if a blockage was found, they'd put in a stent if that was indicated.
No blockage was found.
However, if the doctor had ordered a CT angio and a blockage was found, it might have required a traditional heart cath and stent, or a heart cath and subsequent CABG during his MV repair.

My heart cath experience was good. I was sedated, but awake during the procedure and talked with my cardiologist. His son is also a cardiologist and was also in the OR for the heart cath.

 

[skeptic49]

Here is a pretty interesting recent article about the amount of radiation http://www.msnbc.msn.com/id/29001294/ "CHICAGO - Patients are receiving the equivalent of 600 chest X-rays when they get CT scans for heart disease

That does not square with the information I received when I got my scan in January.
From the University Of Pennsylvania Hospital's web site...Radiology..CT Scan preparation instructions:

This test provides a different and more detailed picture of tissue and bone than is possible with a routine x-ray. The scan itself is painless and very safe. our radiation exposure is slightly more than a routine x-ray.

The web page is here.

 

[Lynlw]

That does not square with the information I received when I got my scan in January.
From the University Of Pennsylvania Hospital's web site...Radiology..CT Scan preparation instructions:


The web page is here.

That's where Justin has his cardiac MRI, The article says there are ways to decrease the amount of radiation but most hospitals don't have them.
"While the potential risk of developing cancer after a cardiac CT scan is slight, at less than 1 percent, researchers in the large, international study found the radiation doses from such tests varied widely among hospitals, suggesting more can be done to minimize patients’ exposure"

( the article also has questions for pateints to ask to get the safest test). My guess is HUP does. I know most of their equipment is state of the art. Justin goes to a couple hosps, but his card at another center said to have his MRIs at HUP since they have the best, and when I was listening to one if the aats webcasts on pericardial replacements, the other surgeon told Dr Bav how impressed he was with their program ect.