Document Detail


Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation.
MedLine Citation:
PMID:  17088461     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multidetector computed tomographic angiography (MDCT) has been shown to allow detection of coronary artery bypass graft (CABG) occlusions and stenoses. However, the assessment of native coronary arteries in addition to CABG has thus far not been sufficiently validated. METHODS AND RESULTS: Fifty patients with a total of 138 CABG (34 mammary grafts, 3 radial grafts, 101 venous grafts) were investigated by MDCT (0.6-mm collimation, 32 detector rows, 2 focal points, 330-ms rotation) 9 to 252 months (mean, 106 months) after surgery. CABG and all native coronary arteries with a diameter of > 1.5 mm were evaluated for the presence of significant stenoses (> or = 50% diameter reduction). Results were compared with quantitative coronary angiography. By MDCT, all CABG were evaluable and were correctly classified as occluded (n=38) or patent (n=100). Sensitivity for stenosis detection in patent grafts was 100% (16/16) with a specificity of 94% (79/84). For the per-segment evaluation of native coronary arteries and distal runoff vessels, sensitivity in evaluable segments (91%) was 86% (87/101) with a specificity of 76% (354/465). If evaluation was restricted to nongrafted arteries and distal runoff vessels, sensitivity was 86% (38/44) with a specificity of 90% (302/334). On a per-patient basis, classifying patients with at least 1 detected stenosis in a CABG, a distal runoff vessel, or a nongrafted artery or with at least 1 unevaluable segment as "positive," MDCT yielded a sensitivity of 97% (35/36) and specificity of 86% (12/14). CONCLUSIONS: We found that 64-slice MDCT permits the evaluation of bypass grafts and the assessment of the native coronary arteries for the presence of stenosis.
Authors:
Dieter Ropers; Falk-Karsten Pohle; Axel Kuettner; Tobias Pflederer; Katharina Anders; Werner G Daniel; Werner Bautz; Ulrich Baum; Stephan Achenbach
Publication Detail:
Type:  Journal Article     Date:  2006-11-06
Journal Detail:
Title:  Circulation     Volume:  114     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-28     Completed Date:  2007-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2334-41; quiz 2334     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine 2, University of Erlangen, Erlangen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Coronary Angiography*
Coronary Artery Bypass*
Female
Follow-Up Studies
Humans
Image Processing, Computer-Assisted
Internal Mammary-Coronary Artery Anastomosis
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Tomography, Spiral Computed / methods*

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


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