Coronary artery bypass graft imaging with 64-slice multislice computed tomography: literature review

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Technology

Background:

• Recurrent cardiac ischemia post-coronary artery bypass graft (CABG) surgery affects many patients.
• Invasive coronary angiography, while definitive, poses risks, costs, and inconvenience.
• Noninvasive methods for assessing bypass graft patency are highly desirable.

Purpose of the Study:

• To review the diagnostic performance of 64-slice multislice computed tomography (MSCT) for coronary artery bypass graft (CABG) imaging.
• To focus on image acquisition, manipulation techniques, and interpretative challenges.
• To consolidate findings from the medical literature regarding 64-slice MSCT accuracy in detecting graft stenosis and occlusion.

Main Methods:

• Systematic review of the medical literature on 64-slice MSCT for CABG imaging.
• Analysis of studies reporting on image acquisition protocols and post-processing techniques.
• Evaluation of reported diagnostic performance metrics (sensitivity, specificity, accuracy) for stenosis and occlusion detection.

Main Results:

• 64-slice MSCT demonstrates increasing accuracy in identifying coronary artery bypass graft stenosis and occlusion.
• Specific image acquisition and manipulation techniques are crucial for optimal diagnostic performance.
• Common interpretative pitfalls have been identified and should be considered during analysis.

Conclusions:

• 64-slice MSCT is a valuable noninvasive tool for evaluating bypass graft patency after CABG surgery.
• Understanding technical nuances and potential pitfalls enhances the reliability of 64-slice MSCT in clinical practice.
• This modality offers a cost-effective and patient-friendly alternative to invasive angiography for recurrent ischemia assessment.