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Published on: March 27, 2018
Coronary bypass graft patency cannot be determined by multidetector spiral computed tomography
Kristian Bartnes1, Trude Sildnes, Amjid Iqbal
1Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway. kristian.bartnes@unn.no
Scandinavian Cardiovascular Journal : SCJ
|April 13, 2006
Summary
Sixteen-slice multidetector computed tomography (MDCT) cannot replace selective angiography for coronary bypass graft patency assessment. MDCT had a 24% non-evaluable rate and a 6% error rate in this study.
Area of Science:
- Cardiovascular Imaging
- Radiology
Background:
- Selective catheterization angiography is the gold standard for coronary bypass graft patency but poses risks.
- Coronary artery bypass grafting (CABG) requires reliable graft patency assessment.
Purpose of the Study:
- To evaluate if 16-slice multidetector computed tomography (MDCT) can serve as a substitute for selective angiography in assessing coronary bypass graft patency.
Main Methods:
- 45 patients underwent both MDCT and selective angiography 2-3 years post-CABG.
- A total of 156 grafts (single and sequential) were analyzed and classified as patent, stenotic, or occluded.
Main Results:
- MDCT showed a high likelihood ratio for detecting occlusion.
- However, 24% of distal anastomoses were unevaluable by MDCT due to artifacts and small vessel size.
- MDCT misclassified 6% of evaluable grafts.
Conclusions:
- 16-slice MDCT is currently not a suitable replacement for selective angiography in coronary bypass graft assessment.
- The high non-evaluable rate and error rate preclude its use as a definitive diagnostic tool.
