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Evaluation of coronary artery bypass grafts using helical scan computed tomography
K Ueyama1, H Ohashi, Y Tsutsumi
1Department of Surgery, Fukui Cardiovascular Center, Japan.
Insights
Helical computed tomographic (CT) scans effectively evaluate coronary artery bypass graft patency. This non-invasive imaging technique demonstrated high accuracy, particularly for vein grafts, aiding post-surgery assessment.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Diagnostic Technology
Background:
- Assessing the patency of coronary artery bypass grafts is crucial for patient outcomes.
- Traditional methods like coronary angiography can be invasive.
- Non-invasive imaging modalities are sought for routine graft evaluation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of helical computed tomographic (CT) scanning for assessing coronary artery bypass graft patency.
- To compare the accuracy of helical CT across different types of grafts (vein, internal thoracic artery, gastroepiploic artery, radial artery).
Main Methods:
- One hundred forty patients underwent helical CT scans and coronary angiography post-bypass surgery.
- A total of 398 grafts and 436 anastomoses were analyzed.
- Accuracy was calculated for various graft types, including sequential anastomoses.
Main Results:
- Helical CT showed high accuracy for vein grafts (96.4%) and correct positive ratio (99.5%).
- Accuracy varied for arterial grafts: internal thoracic artery (64.7%), radial artery (45.5%), and gastroepiploic artery (33.3%).
- Venous sequential anastomoses had an overall accuracy of 73.0% with helical CT.
Conclusions:
- Helical computed tomographic (CT) scanning is a useful, non-invasive tool for evaluating coronary artery bypass graft patency.
- The technique is highly accurate for assessing vein grafts but shows lower accuracy for certain arterial grafts.
- Helical CT can aid in the routine assessment of bypass graft status before patient discharge.
Abstract:
The patency of coronary artery bypass grafts was evaluated by helical computed tomographic (CT) scan. One hundred forty patients who received an enhanced chest CT scan and a coronary angiography after bypass surgery were studied before discharge at the Fukui Cardiovascular Center. Among them was a total of 398 grafts and 436 anastomoses. For the evaluation of 248 vein grafts, the CT scan showed a 99.5% correct positive ratio and an overall accuracy of 96.4%. In 122 internal thoracic arteries tested, an overall accuracy of 64.7% was obtained. In gastroepiploic artery tests the overall accuracy was 33.3% and in radial artery tests it was 45.5%. Thirty-seven venous sequential anastomoses in 34 grafts and 1 internal thoracic artery sequential anastomosis were also evaluated. In the venous sequential anastomosis, the CT scan showed a 73.0% of accuracy overall. This study showed that the helical CT scan was useful to evaluate graft patency following bypass surgery.