J Korean Radiol Soc.  2006 Nov;55(5):451-459. 10.3348/jkrs.2006.55.5.451.

Noninvasive Follow-Up of Coronary Artery Bypass Graft Patency Using Multi-Slice Computed Tomography

• Joo SH
• Choi BW
• Seo JS
• Kim YJ
• Kim TH
• Choe KO
• Choi D
• Yoo KJ

• KMID: 2024463
• DOI: http://doi.org/10.3348/jkrs.2006.55.5.451

Abstract

PURPOSE
We wanted to evaluate the utility of multi-slice computerized tomography (MSCT) for assessing coronary artery bypass graft patency and/or occlusion.
MATERIALS AND METHODS
For 24 patients, both conventional angiography and CT angiography with 4-MSCT were performed within seven days of one another in order to evaluate the accuracy of MSCT with regard to graft patency and/or occlusion. A follow-up CT angiogram was performed in patients with and without symptoms (n=11, n=34, respectively) with 4- or 16-MSCT. We retrospectively compared the results of MSCT to those of conventional coronary graft angiography.
RESULTS
Sixty-five grafts were evaluated for the accuracy of MSCT. Six of those 65 were occluded. The sensitivity, specificity, positive predictive value and negative predictive values of MSCT for the diagnosis of graft occlusion were 100% (6/6), 98% (58/59), 86% (6/7) and 100% (58/58), respectively. Patency could not be determined by angiography in two grafts; however, the grafts proved to be patent on MSCT. On follow-up, new graft occlusions in the asymptomatic patients were detected by MSCT in 8.2% of the previously patent grafts at the two years post-op, and in 15.2% at the three years post-op.
CONCLUSION
MSCT is a practical and accurate noninvasive diagnostic tool for following up coronary artery bypass grafts.

Keyword

Computed tomography (CT); Coronary vessels, surgery; Grafts; Graft patency

MeSH Terms

Angiography
Coronary Artery Bypass*
Coronary Vessels*
Diagnosis
Follow-Up Studies*
Humans
Retrospective Studies
Sensitivity and Specificity
Transplants