Multidetector Computed Tomography in the Preoperative Assessment of Cardiac Surgery Patients

Over the last 50 years, the volume of cardiac surgery has increased and associated operative morbidity and mortality has decreased secondary to advances in surgical technique, cardiopulmonary bypass, imaging, and perioperative care. There has been an increase in complex cardiac disease due to the aging population, who often present with severe coronary artery and degenerative valvular disease. These patients often require reoperative valvular surgery and coronary artery bypass grafting (CABG), and are frequently candidates for cardiac surgery. A recent study has shown that aortic valve replacement can be performed in octogenarians with acceptable surgical outcomes. Chest radiography, echocardiography (echo), and catheter angiography traditionally have been the primary modalities in the preoperative imaging evaluation of cardiac surgical patients. Improvements in multidetector computed tomography (MDCT) technology allow MDCT to play an increasing role in noninvasive cardiac imaging. Increased numbers of detector rows with MDCT enhance the depiction of small structures such as coronary arteries with ever improving spatial resolution and anatomic coverage. Significant reduction in cardiac motion artifacts is possible with the improved temporal