Skip to content

Gated CTA CAP Sternotomy Revision

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Gated CTA Chest Arterial (bolus tracked) Thoracic inlet to Diaphragm
    Flash AP Contrast (Immediate delay) Diaphragm to Pubic symphysis
    Venogram Chest Contrast (60 sec delay) Thoracic inlet to Diaphragm
    • Pre-operative planning for redo sternotomy
    • Retrosternal structures assessment

  • 2. Patient Prep

    • Position: Supine with arms raised
    • NPO Status: NPO 4 hours
    • Pre-Medication:
      • HR < 65 target. Premedication not required.

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 1.2 mL/kg
    Flow Rate 5 mL/s
    Duration 15s
    Timing Method Bolus Tracking
    ROI Placement Ascending aorta
    Trigger (HU) 180 HU

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • THREE acquisitions: 1) Gated CHEST 2) Flash AP arterial 3) CHEST venogram 60 sec delay. Venous for retrosternal structures
    • Additional Recons: 3D VR venogram highlighting retrosternal veins. Distance measurements sternum to heart
    • 20G IV

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Large contrast load - verify renal function
    • Gated: cardiac anatomy. Arterial: systemic vessels. VENOUS: retrosternal veins and adherent structures critical for surgical planning
    • Venous phase critical for surgical planning. Map all retrosternal structures
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Thoracic inlet Pubic symphysis N/A N/A AP lateral full
Gated CTA Chest Thoracic inlet Diaphragm Bolus tracked 0.5-0.625 mm Retrospective gating
Flash AP Diaphragm Pubic symphysis Immediate 0.625 mm Arterial phase AP
Venogram Chest Thoracic inlet Diaphragm 60 sec 1 mm Retrosternal venous structures
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Gated chest Chest 0.75 mm/0.75 mm Cardiac 3 Cardiac and coronary anatomy
Axial Venogram Chest 1.25 mm/1.25 mm Standard 3 Critical for retrosternal structures
Coronal All phases Chest 2 mm/2 mm Standard 3 Anterior chest wall structures
3D VR Venogram Chest 1 mm source Standard 3 3D map retrosternal vessels for surgery