Cardiac CT Angiography (Herz-CT)

ECG-gated contrast-enhanced CT angiography of the coronary arteries on a 640-slice Canon Aquilion ONE GENESIS scanner — the world's highest-slice-count cardiac CT. Single-heartbeat acquisition with minimal radiation. Led by PD Dr. Tiemann and Prof. Ley at Munich's specialist cardiac hospital. GOÄ self-pay estimate ~€390.

Cardiac CT angiography (CCTA) at Osypka Herzzentrum München is performed on the 640-slice Canon Aquilion ONE GENESIS scanner, the most advanced cardiac CT technology available. Where standard 64- or 128-slice scanners must acquire cardiac data over two to four heartbeats, the 640-slice architecture captures the entire heart volume — from the aortic root to the cardiac apex — in a single gantry rotation during one diastolic pause. This one-beat acquisition eliminates the step-and-shoot artefacts that arise when separate detector sweeps are merged, and produces seamless 3D coronary artery maps even in patients with higher resting heart rates who would otherwise require higher beta-blocker doses or be referred for invasive catheter angiography. The clinical output is a comprehensive assessment of coronary anatomy: left main, left anterior descending, left circumflex, ramus intermedius, and right coronary artery are evaluated for stenosis, calcified and non-calcified plaque burden, coronary anomalies, and post-stent or post-bypass patency. Sub-millimetre in-plane resolution allows confident characterisation of plaques at the borderline between non-obstructive and haemodynamically significant. Fractional flow reserve estimates derived from the CT dataset (CT-FFR) can be calculated when lesion significance is uncertain, avoiding additional invasive assessment. Radiation dose with the one-beat protocol is substantially lower than multi-beat acquisitions on older-generation scanners. Canon's AIDR 3D iterative reconstruction algorithm reduces image noise without sacrificing spatial resolution, supporting dose reduction to below 1 mSv in patients with slow regular rhythms. This positions cardiac CT at the OHZ firmly within the dose range of a standard chest X-ray series — a relevant consideration for repeat imaging in follow-up protocols. The OHZ cardiac imaging team is led by PD Dr. Klaus Tiemann and Prof. Ley. Examination preparation includes pre-scan ECG assessment and, when indicated, oral beta-blocker preparation the evening before. Intravenous contrast is injected via a peripheral cannula timed to maximise coronary opacification. The structured report addresses per-segment stenosis grading (SCCT classification), plaque characterisation, and a risk summary aligned with current ESC guidelines for stable chest pain. The centre accepts direct self-pay bookings and accepts statutory insurance referrals from cardiologists throughout Bavaria. For patients with elevated coronary calcium scores suggesting extensive calcification that may limit CTA interpretation, the team advises pre-scan consultation to assess whether functional testing or direct catheter angiography is a more appropriate pathway — reducing unnecessary contrast exposure. The integration of CT imaging, electrophysiology, and interventional cardiology within the same facility means that patients with significant findings can proceed to further workup or treatment without a change of institution.