64-slice multidetector computed tomographic evaluation of arterial conduit patency after off-pump coronary artery...

We set out to evaluate the accuracy of 64-slice multidetector row computed tomography (MDCT) in the evaluation of graft patency in 25 unselected patients who underwent off-pump revascularization with arterial conduits. A total of 73 coronary artery bypass grafts were examined by means of 64-slice MDCT. Postoperative clinical outcomes were also evaluated as indicators of early coronary bypass malfunction. Serial data from cardiac-specific biomarkers and from hemodynamic results were obtained in all patients. Two radiologists analyzed the MDCT images and reached consensus.No patients had evidence of postoperative acute myocardial infarction. Transient postoperative reduction of 5% to 8% in left ventricular ejection fraction was detected in 4 patients, independently of elevated biomarker serum levels. A total of 73 conduits were available for the analysis. Two grafts were judged not evaluable because of poor visualization due to irregular heartbeat. The image quality was excellent in all other scanned grafts and anastomoses.We conclude that 64-slice MDCT technology enables accurate and reliable visualization of coronary bypass grafts with arterial conduits. We believe that it can be performed in large populations of postoperative bypass patients as a realistic alternative to coronary angiography.