Document Detail


Comparison of multidetector 64-slice computed tomographic angiography to coronary angiography to assess the patency of coronary artery bypass grafts.
MedLine Citation:
PMID:  17531575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study prospectively evaluated the diagnostic accuracy of 64-slice computed tomographic angiography (CTA) in assessing the patency of coronary artery bypass grafts compared with invasive coronary angiography. In total 147 bypass grafts (100 venous grafts and 47 mammary artery grafts) were evaluated in 50 consecutive patients. Contrast-enhanced 64-slice CTA was performed and compared with invasive angiography. The computed tomographic angiographic scan protocol used 64- x 0.5-mm slice collimation and 0.33-second gantry rotation time during simultaneous electrocardiographic gating. Patients with a heart rate >65 beats/min received beta blockers. Overall 145 of 147 bypass grafts (98.6%) were detected by CTA; 2 nonvisualized grafts were occluded at the time of invasive angiography. Of the grafts visualized, 28 were totally occluded, 103 were patent, and 14 had significant stenoses that were confirmed by invasive angiography. Ninety-five percent (111 of 117) of patent grafts demonstrated good run-off distal to anastomoses but without an ability to accurately evaluate the presence of retrograde flow; 83% (97 of 117) of distal anastomoses were adequately evaluated, whereas the remaining 17% (20 of 117) were not well visualized due to vascular clips and/or calcification artifacts. Two grafts were not demonstrated by invasive angiography but were detected by CTA and found to be widely patent. In conclusion, multidetector 64-slice CTA is a valuable tool for direct visualization of coronary bypass grafts and assessment of their patency. Dysfunctional bypass grafts can be detected with high diagnostic accuracy.
Authors:
Refat Jabara; Nicolas Chronos; Larry Klein; Steven Eisenberg; Rebecca Allen; Shannon Bradford; Stephen Frohwein
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2007-04-13
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-28     Completed Date:  2007-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1529-34     Citation Subset:  AIM; IM    
Affiliation:
Saint Joseph's Research Institute/Saint Joseph's Hospital of Atlanta, Georgia, USA. rjabara@sjha.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Artificial Intelligence
Coronary Angiography*
Coronary Artery Bypass*
Coronary Circulation
Coronary Stenosis / epidemiology,  physiopathology*,  radiography*,  surgery
Cross-Sectional Studies
Electrocardiography
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Observer Variation
Prospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed* / methods
Treatment Outcome
Vascular Patency*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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