...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Academic radiology >Impact of coronary ct angiography on surgical decision-making for coronary artery bypass graft surgery
【24h】

Impact of coronary ct angiography on surgical decision-making for coronary artery bypass graft surgery

机译：冠状动脉造影对冠状动脉搭桥术的手术决策的影响

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Rationale and Objectives: To determine the impact of coronary computed tomography angiography (CCTA) on treatment decisions made by cardiac surgeons and to explore barriers to implementation of CCTA as first-line imaging workup before coronary artery bypass. Materials and Methods: Tertiary academic medical center retrospective cohort study. Questionnaires administered to three cardiac surgeons regarding diagnosis and treatment decisions with level of confidence in decision making for 30 chest pain patients, after reviewing deidentified catheter coronary angiogram (CCA) and CCTA images on the same patients, several weeks apart. Results: All surgeons tended to report more severe disease with CCTA than CCA (P < 05). Treatment decisions differed in 12 (40%), 14 (47%), and 18 (60%) patients within each individual surgeon based on CCTA images compared to CCA images (P = 11, .01, and .02, respectively). Confidence levels were significantly higher with CCA for the diagnosis and treatment of coronary artery disease for all three surgeons (P < .05). There was a tendency toward more invasive treatment choices (angioplasty, stent insertion, or coronary artery bypass graft) when making treatment decisions based upon CCTA images. Conclusions: Severity of disease may be overestimated by cardiac surgeons when using CCTA as a decision-making test, tending toward more invasive treatment choices compared to CCA. Additionally, cardiac surgeons may be more confident with their diagnosis and treatment based on CCA. These may be important limitations in the application of CCTA in clinical practice and may reflect the maturation of CCTA use in practice, diffusion of the technology and/or a reflection of the technology itself.
机译：原理和目的：确定冠状动脉计算机断层扫描血管造影（CCTA）对心脏外科医生做出的治疗决定的影响，并探讨在冠状动脉搭桥术前进行一线显像检查时实施CCTA的障碍。资料与方法：第三学术医学中心回顾性队列研究。向30名胸痛患者的决策者充满信心地对三名心脏外科医师进行了有关诊断和治疗决策的问卷调查，在对同一名患者进行了不明身份的导管冠状动脉造影（CCA）和CCTA图像检查后，相隔数周。结果：所有外科医生倾向于报告CCTA的病情比CCA更严重（P <05）。与CCA图像相比，根据CCTA图像，每个独立外科医生中的12位（40％），14位（47％）和18位（60％）患者的治疗决定有所不同（分别为P = 11、0.01和0.02）。三位外科医生对CCA诊断和治疗冠状动脉疾病的置信度显着更高（P <.05）。根据CCTA影像做出治疗决策时，倾向于选择更具侵入性的治疗选择（血管成形术，支架插入或冠状动脉搭桥术）。结论：当使用CCTA作为决策测试时，心脏外科医生可能会高估疾病的严重程度，与CCA相比，倾向于选择更具侵入性的治疗选择。此外，心脏外科医生对基于CCA的诊断和治疗可能更有信心。这些可能是CCTA在临床实践中应用的重要限制，并且可能反映出CCTA在实践中的使用日趋成熟，技术的普及和/或技术本身的体现。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号