Computed tomography angiography for the interventional cardiologist

In recent years, coronaryCTangiography(CCTA) hasbecome a widely adopted technique, not only due to its high diagnostic accuracy, but also to the fact that CCTA provides a comprehensive evaluation of the total (obstructive and non-obstructive) coronary atherosclerotic burden. More recently, this technique has become mature, with a large body of evidence addressing its prognostic validation. In addition, CT angiography has moved fromthe field of 'imagers' and clinicians and entered the interventional cardiology arena, aiding in the planning of both coronary and structural heart interventions, being transcatheter aortic valve implantation one of its most successful examples. It is therefore of utmost importance that interventional cardiologistsbecomefamiliar with image interpretation and up-to-date regarding severalCTAfeatures, taking advantage of this information in planning the procedure, ultimately leading to improvement in patient outcomes.Onthe other hand, the increasing use ofCCTAas a gatekeeper for invasive coronary angiography is expected to lead to an increase in the ratio of interventional to diagnostic procedures and significant changes in the daily cath-lab routine. In a foreseeable future, cath-labs will probably offer an invasive procedure only to patients expected to undergo an intervention, perhaps becoming in this change true interventional-labs.

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