[Use of multidetector-row computed tomography in a patient with completely obstructed left anterior descending...

Multidetector-row computed tomography (MDCT) is a useful diagnostic procedure prior to coronary artery bypass grafting (CABG) as it visualizes the coronary artery less invasively, with higher negative predictive value and lower cost compared with standard coronary angiography (CAG). We recently experienced a case in which the left anterior descending artery (LAD) occlusion prevented CAG evaluation of peripheral vascular status and percutaneous coronary intervention (PCI) or CABG could not be indicated by CAG, whereas MDCT demonstrated a patency of the peripheral LAD. An off-pump coronary artery bypass surgery was performed based on the MDCT findings, and the intraoperative findings were essentially consistent with the MDCT findings. Our experience in this case suggests that the indication for CABG may be accurately judged by using high-resolution MDCT in cases in which CABG graftability may not be judged by CAG.