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Direct non-invasive techniques for assessing coronary bypass graft patency
International Journal of Cardiac Imaging
|January 1, 1985
Summary
Computed tomography (CT) and venous digital subtraction angiography (vDSA) are non-invasive methods for imaging coronary grafts. Combining CT and vDSA accurately assesses bypass graft patency, potentially avoiding invasive selective angiography.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Radiology
Background:
- Coronary artery bypass grafting (CABG) is a common procedure.
- Assessing the patency of coronary grafts is crucial for patient outcomes.
- Non-invasive imaging techniques are desirable to evaluate graft status.
Purpose of the Study:
- To compare the diagnostic accuracy of computed tomography (CT) and venous digital subtraction angiography (vDSA) for evaluating coronary bypass graft patency.
- To determine if combining CT and vDSA can improve diagnostic accuracy and potentially replace selective angiography.
Main Methods:
- Fifty-two patients with 107 coronary grafts (101 saphenous vein grafts, 6 internal mammary artery grafts) underwent both CT and vDSA.
- Fifty patients had selective angiography, and 2 had digital arterial aortography as controls.
- Diagnostic accuracy for patent and occluded grafts was compared between CT, vDSA, and control angiography.
Main Results:
- CT correctly diagnosed 88/95 patent grafts and 8/12 occluded grafts.
- vDSA correctly identified 93 patent grafts and 12 occluded grafts.
- vDSA correctly diagnosed 11 grafts misdiagnosed by CT, while CT corrected 2 vDSA misdiagnoses.
- Agreement between CT and vDSA indicated no diagnostic errors.
Conclusions:
- When CT and vDSA results agree, diagnostic accuracy for coronary bypass graft patency is high.
- The combination of CT and vDSA may serve as a reliable non-invasive strategy to assess coronary bypass graft patency, potentially obviating the need for selective angiography.