CARDIAC COMPUTED TOMOGRAPHY ANGIOGRAPHY (CCTA)

Cardiac computed tomography angiography (CCTA) is an imaging method that uses a computed tomography (CT) scanner to look at the structures and blood vessels of the heart. . CT scans use X-ray technology and advanced computer analysis to create detailed pictures of the body. CCTA uses imaging contrast injected through a vein in the arm and takes pictures of the heart vessels from outside the body. It is a noninvasive alternative to the traditional cardiac catheterization (cath) angiogram. The cardiac cath has long been considered the gold standard in evaluating coronary artery disease. However, it is an invasive procedure that carries with it certain risks for complications. CCTA uses the most advanced CT scanner technology to create detailed three dimensional pictures of the heart. Cardiologists are able to determine if there are any blockages in the arteries of the heart, as well as evaluate cardiac structures.

A CT scanner is a large, box-like machine with a hole, or short tunnel, in the center. A patient will lie on a narrow examination table that slides into and out of this tunnel. Rotating around you is the x-ray tube and electronic x-ray detectors, which are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is located in a separate room, where the technologist operates the scanner and monitors your examination.

CT technology has been used in medicine for over thirty years, but until recently the scanners have not been able to take pictures fast enough to image the heart, which is constantly beating. The latest scanners are now able to take 64 or more pictures a minute, allowing doctors to take a snapshot of the heart in between beats.

CCTA VS CATH

CCTA and cardiac cath are both good procedures that can help doctors evaluate your coronary arteries. When choosing which procedure is best for you, you should consult with your doctors.

There are several advantages of CCTA:

  • It is a non-invasive procedure, and the risk of complications is lower than for cath.
  • The total time for preparation, procedure and recovery is shorter than cath.
  • CCTA can provide details about the structure of the artery walls, including "soft plaques" which are fatty deposits that increase your risk for future cardiac disease.
  • CCTA has a very high "negative predictive value", which means it is a very good test for ruling out cardiac disease.

Disadvantages:

  • CCTA has a higher radiation dose than cardiac cath, which carries with it a small risk of complications.
  • Because there is no catheterization with CCTA, it is a diagnostic test only. If blockages are found, a separate procedure will be needed to treat the blockages. With cardiac cath, a procedure called angioplasty (PTCA) can be performed during the angiogram, if a doctor determines that it is necessary. The doctor can also insert a device called a stent which can help keep the blood vessels open.
  • The level of detail is not yet sufficient enough to evaluate the smaller vessels branching from the coronary arteries, so if you have known CAD or other strong evidence of narrowing of the coronary arteries, a cardiac cath may be the better alternative.
  • Extremely overweight patients or patients with abnormal heart rhythms may reduce image quality making a diagnosis difficult

PREPARING FOR A CCTA PROCEDURE

You must not drink or eat at least 4 hours prior to the procedure.

According to the recommendation of American College of Radiology regarding the intravenous contrast given to contrast enhanced CT and CTA procedures, all patients scheduled for CTA with contrast must have a serum CREATININE and BUN within the past 90 days.


BEFORE A CCTA PROCEDURE

Patient should wear comfortable, loose-fitting clothing for any CT procedure and leave all jewelry and valuables at home.

Please bring the followings items:

  • Prescription or referral from referring physician
  • Insurance cards and identity cards issued by government
  • Laboratory results containing a serum CREATININE and BUN within the past 90 days

DURING A CT PROCEDURE

WHERE IS THE PROCEDURE PERFORMED?

Our CCTA procedures are conducted at Synergy Imaging Center which is located directly above our main SCHC Medical Offices at 506 W. Valley Blvd in San Gabriel.

WHAT WILL HAPPEN DURING THE PROCEDURE?

The CT technologist will explain the procedure and answer any questions you may have before positioning you on the exam table.

The CT technologist will insert a small IV in your arm if a contrast is prescribed by referring physician. Patient must inform the technologist of any allergies he or she may have before exam. If contrast dye is being used, it will be injected through patient's IV line. During the injection, patients may experience a warm sensation throughout their body and a metal taste in their mouth. This is normal. If a patient experiences any itching, sneezing, nasal congestion, scratchy throat or swelling on face, the patient should notify the technologist immediately.

You will be asked to lie flat on your back with your arms over your head. The table will move into scanner. The scanner is open at the back and the front, allowing the patient to see out. The technologist will always be able to see and hear the patient during exam. You will be asked to lay still and may be asked to hold your breath briefly when the pictures are taken.

A CCTA procedure usually takes approximately 15 to 30 minutes.


AFTER A CCTA PROCEDURE

After a CT procedure, you can resume normal activity. If contrast has been administered, you should drink plenty of liquid for the next few days.

All the CT studies will be reviewed by a cardiologist who specializes in interpretation of CCTA images. The results will be sent to the referring physician. To request a copy of medical record images on a CD, or a copy of report, please contact our office. They will be provided upon request for a nominal fee.