Perspective:

This study demonstrates that CCTA has high accuracy to identify obstructive CAD (defined as a stenosis ≥50%) in patients planned for valve surgery. Patients with aortic stenosis had a higher rate of false-positive studies, which may be expected as these patients may have increased coronary calcification, which can result in calcification ‘blooming’ and overestimation of lesion stenoses. It is important to note that some of the studies excluded noninterpretable segments from the analyses, which can bias the results. Further, the meta-analysis does not explicitly state how many patients had prior coronary revascularization, and it should be noted that CCTA has marked limitations in assessing stent patency. Overall, the study supports a potential role in CCTA prior to vascular surgery in patients considered to be at low or intermediate risk of CAD.