Services | CT Coronary Angiography
CT Coronary Angiography is now being performed on the new Toshiba Aquilion 64 Row CT scanner at SCR’s Southport Rooms. The Toshiba Aquilion 64 is the first scanner of its type on the eastern seaboard of Australia, and is able to produce high resolution images of the Coronary Arteries and surrounding anatomy. These images are of a quality unattainable before the introduction of 64 Row technology.
Who is suitable for CTCA?
Patients must have slow and stable heart beat (65bpm or less). If the heart rate at the time of scan is >65bpm the images obtained may have substantial motion artefact. Patients must be able to remain motionless for the short duration of the scan – no swallowing or breathing.
Beta-Blockade
All CT Coronary Angiograms are performed using ECG Gating and fast scan times to effectively freeze heart motion. CTCA is ideally performed when the patient’s heart rate is < 65 bpm. South Coast Radiology requests that all patients with a resting heart rate > 65bpm be beta-blockaded prior to study. Prescription of a suitable beta blocking agent is the responsibility of the referring doctor. After consultation between Radiologists and Cardiologists, SCR recommends Metoprolol 50mg, twice a day (BD) for two days prior to study. Metoprolol is a short acting beta blockade with good lowering of the heart rate. Contraindications are to be assessed by the referring doctor. For further information please contact the radiology nurse at SCR Southport on 5591 8366.
How accurate is CTCA?
CTCA is able to measure the degree of stenosis in the coronary arteries, and whether this is due to soft plaque and/or calcified plaque. The gross anatomy of the heart is also visualized. SCR is working alongside Cardiac Specialists to ensure that the data that is produced is congruent with current standards of coronary catheter angiography. It is important to note that interventions (eg. Angioplasty) cannot be performed during CTCA.
Coronary Artery Calcium Scoring (CACS)
Patient’s with severe and/or diffuse calcific atherosclerosis pose a potential problem for CTCA because large deposits of calcification in the coronary arteries can obscure the lumen. SCR will perform a CACS on each patient prior to CTCA to exclude large amounts of calcified atheroma. The results of the CACS will be reviewed by the attending radiologist to ensure that the CT Coronary Angiogram can be performed accurately. There is no extra charge for the CACS study.
Radiation Dose
With any x-ray examination the benefit of having the examination has to be weighed against the small, but not zero, risk from the ionizing radiation. CTCA produces a dose less than conventional cardiac catheterization. Toshiba’s SURE Exposure™ ensures optimum image quality at minimum patient dose, by adjusting the tube current during scanning, often reducing total dose by up to 40 percent per patient.
CTCA Referrals
CTCA can be referred on our general referral pads (check the box marked CT Coronary Angiography). Please indicate any previous cardiac surgery that the patient may have had, and the sites of any stents/grafts if known. Patient information will be listed on the reverse of the referral.
Please contact SCR Administration on (07) 5575 5911 if you require more referral pads.
Is CTCA Medicare Rebatable?
On the 1st May 2006, Medicare moved to exclude CT Coronary Angiography from the Schedule of rebatable CT procedures. This does not mean the study cannot be performed, only that it will not attract a rebate even when referred by a specialist or is combined with other stdies such as a CT Pulmonary Angiogram.
South Coast radiology is hopeful that as occurred with CT Colonoscopy, the rebate will be re-introduced once it becomes more obvious just how important this investigation is to the entire community. Until such time we will provide Ct Coronary Angiography to all patients at a reduced Private Fee of $300.
Who performs the CT Coronary Angiogram?
CTCA is performed by specialist CT Radiographers under the guidance of a Radiologist. The images are reconstructed using a state of the art Toshiba Workstation to produce 3D Volume and Planar images of the arteries of the heart. Images can be displayed in a variety of formats including “Angio-simulation” to recreate Angiographic style images.
Who Interprets the Results?
A core group of cardiac radiologists will be analysing and reporting on the results of the CT Coronary Angiogram.
When are the results available?
Reconstruction of the CTCA Images takes time. Patients are required to return to the referring doctor to obtain results. Films can be delivered, or the patient can return to collect results the following day.