The topic today is the cardiac computed tomography angiography, or CCTA. This procedure is a more recent option for heart imaging that some may compare to the traditional cardiac catheterization or heart cath. While both procedures take images of the heart and assist in detecting blockages, the two procedures are different.
The heart cath remains the “gold standard” for the detection and treatment of blockages in the coronary arteries. Because it is an invasive procedure that is performed internally , the heart cath generates very accurate images of the arteries and allows the physician to perform immediate intervention, such as stent placement, if a worrisome blockage is found. Sometimes the heart cath will show lesser blockages that the physician will note for ongoing monitoring. The heart cath is appropriate for high-risk patients and those who have known coronary artery disease (CAD) and are symptomatic. During the procedure, a catheter inserted into a vessel in the groin or arm goes up to the heart where imaging contrast in injected directly into the coronary arteries to produce detailed images of the coronary arteries.
The CCTA is a noninvasive procedure that takes images from outside the heart. Imaging contrast is injected via a small needle into a vein in the arm, and the contrast travels to the heart to produce images using CT technology. The CCTA images are less detailed than those generated from the heart cath but are detailed enough to enable physicians to make decisions with a high degree of accuracy. The CCTA allows physicians to measure calcium in the walls of the coronary arteries, which is useful information to estimate the risk level of the patient for a cardiac event and determine an appropriate proactive treatment plan. The CCTA also can create 3-D models of the heart, which helps physicians evaluate heart abnormalities that were present from birth and provides data that assist in procedures involving the heart’s electrical system.
The CCTA offers yet another choice in addition to the heart cath and the stress test to get valuable information about the heart. It remains a viable option in certain circumstances, such as when patients are not able to endure optimal stress testing, when a CCTA can help identify known or suspected structural heart defects, when newly diagnosed cardiomyopathy calls for an evaluation of the coronary arteries, and when the anatomy of the patient’s heart will assist in performing another heart procedure. The patient’s physician will determine the tests or procedures, if any, that are most appropriate for each patient.
At SIR, the CCTA is expertly performed by Dr. Gerald E. Grubbs, interventional radiologist who is fellowship-trained from the Miami Cardiac and Vascular Institute at Baptist Hospital of Miami and who specializes in diagnostic, cardiovascular and interventional radiology. For more information about the CCTA or other offerings at SIR, call 941-378-3231.