Development of a Cardiac CT Program: The First 100 Cases

Much like echocardiography in the 1980s, cardiac CT is an emerging technology in veterinary medicine that allows us to visualize the heart and associated pathologies in new ways. The author has built a new program in cardiac CT over the last 2 years and now images 50+ cases per year by CT. Advantages of cardiac CT over traditional imaging modalities include the ability to visualize the heart in any spatial plane, to understand complex 3D relationships, to size and plan for interventional device therapies, to visualize the vasculature and surrounding extracardiac structures not apparent by ultrasound imaging, and to provide a gold-standard quantification of cardiac volumes. While research papers exist detailing the use of cardiac CT in normal dogs or rare case reports, little information exists about how to develop a clinical program and generate or optimize CT protocols that are specific to heart defects encountered in clinical practice. This lecture will describe the pathway to routine clinical use of cardiac CT in animals, highlighting the challenges encountered and overcome related to patient size, heart rate, shunting defects, and contrast timing.