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Gated CTA Chest Post-op Cardiac Valve

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Non-contrast Non-contrast Lung Apices to Diaphragm
    Gated CTA Arterial (bolus tracked) Top of heart to Below heart
    • Post-operative valve assessment
    • Prosthetic valve evaluation
    • Post-surgical complications

  • 2. Patient Prep

    • Position: Supine feet-first
    • NPO Status: NPO 2-4 hours
    • Pre-Medication:
      • HR < 65 preferred. Metoprolol if needed

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 1.3 mL/kg
    Flow Rate 4-5 mL/s
    Duration 15 sec
    Timing Method Bolus Tracking
    ROI Placement Ascending aorta
    Trigger (HU) 200 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

    • Retrospective gating. INCREASED kV to 130-140 for metal artifact reduction. Increased contrast 1.3 mL/kg. Extended reconstruction phases
    • Additional Recons: Multi-phase reconstructions. Valve-specific views. Paravalvular assessment
    • 20G IV minimum

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history
    • Assess prosthetic valve function. Look for paravalvular leak. Evaluate perivalvular complications. Metal artifact reduction critical
    • Increased kVP and increased contrast volume with thinner cuts help with seeing through metallic artifact to evaluate for thrombus.
    • High kV (130-140) critical for metal artifact. Increased contrast volume
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Top of chest Diaphragm N/A N/A AP lateral
Gated CTA Top of heart Below heart Bolus tracked 0.5-0.625 mm Retrospective gating HIGH kV
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Gated CTA Heart 0.75 mm/0.75 mm Cardiac 3 Prosthetic valve assessment
Axial Gated CTA Heart Multi-phase Cardiac 3 Multiple cardiac phases for motion
Short axis Gated CTA Valve level 1 mm Cardiac 3 En face valve views
Long axis Gated CTA Heart Multi-phase Cardiac 3 Valve motion assessment