Implementação de angiotomografia de coronárias no Hospital Universitário da Universidade Federal de Sergipe

Abstract

Background: The University Hospitals provide relevant tertiary level services to the users of the Unified Health System. The current guidelines recognize the Coronary Computed Tomography Angiography (CCTA) as a very useful method in the diagnosis and risk stratification of the coronary artery disease (CAD). Therefore, this research aims to demonstrate barriers and facilitators to the implementation of the CCTA service at the University Hospital of the Federal University of Sergipe (HU) as well as clinical features and results of the first 50 patients. Method: This is a hybrid study on the implementation of the CCTA at HU. We conducted a checklist of barriers and facilitators to structure the service, with a professional expert in the methodology. We elaborated a systematic protocol to follow, which ranges from the purchase of the scanner, the whole training of personnel, to the application of a specific model for the preparation of reports. We applied specific questionnaires for the evaluation of patients undergoing examination. Results: The main facilitators were: a) the guidance provided by doctors from HU concerning the indications of the exam, b) Funding of print material by CNPq, c) Meetings with members of Toshiba, Bayer and Medrad, d) The presence of one coordinator and one research group, which produces scientific papers on CCTA. The main difficulty was the resistance from technologists and radiologists regarding the implementation of the new service. However, we considered the execution of the project viable, sustainable and well accepted in the local community. To this moment, tests have been conducted in patients with intermediate probability for CAD. Mean age was 56.72 ± 10.96, 48% were men. Exam results show that 40% had calcium score (CS) equal to zero and 60% had high CS; 64% of sample exhibited plates and 26% did not. Conclusion: HU CCTA service is working fully, benefiting the population and favoring local scientific production. The creation of a protocol was essential for the service to be considered viable and sustainable and to the acceptance by the local community. The tests performed showed that it was possible to exclude the presence of obstructive CAD in 26% of cases.