Document Detail


Sixteen-slice multidetector computed tomography for graft patency evaluation after coronary artery bypass surgery.
MedLine Citation:
PMID:  18290881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the ability of 16-slice multidetector computed tomography (MDCT) to assess coronary artery bypass graft patency and to detect bypass stenosis by comparison with coronary angiography. METHODS: Thirty patients underwent both conventional coronary bypass angiography and retrospective ECG gated 16-slice multidetector computed tomography after surgery using 0.4 seconds rotation time and 1.25 mm slice thickness. RESULTS: Among a total of 107 bypass grafts, 101 grafts (94.4%) were evaluable by MDCT. Thirteen patients were taking oral beta blockers. Mean heart rate was 73.6 (52-105). Of the 40 internal mammary arteries and two radial arteries examined, only one was occluded by coronary bypass angiography and MDCT, resulting in a sensitivity of 100% and a specificity of 100%. MDCT correctly diagnosed all patent venous grafts and missed two of the 14 venous grafts shown occluded by conventional angiography resulting in a sensitivity of 85.7% and specificity of 100%. When occluded grafts were excluded, MDCT did not detect two out of two anastomotic arterial graft stenosis >50% and resulted in one false positive result for a sensitivity and specificity of 0% and 97.4%, respectively. MDCT correctly diagnosed one out of three venous stenosis >50% and falsely diagnosed one venous graft stenosis >50% yielding a 33.3% and 97.6% sensitivity and specificity, respectively. CONCLUSION: Sixteen-slice MDCT allows for noninvasive evaluation of coronary bypass grafts patency with high diagnostic accuracy. Assessment of distal anastomotic stenosis was deficient, particularly for arterial grafts, still limited by low resolution or artifacts. Improved accuracy may be obtained by more aggressive heart rate reduction.
Authors:
Miguel Sousa Uva; Fernando Matias; Armindo Mesquita; Rogério Costa; José Baú; Albino Pedro; Manuel Pedro Magalhães
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2008-02-22     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-22     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal. miguel.uva@hcvp.com.pt
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Coronary Angiography
Coronary Artery Bypass*
Coronary Artery Bypass, Off-Pump
Coronary Restenosis / radiography*
Female
Graft Occlusion, Vascular / radiography*
Humans
Internal Mammary-Coronary Artery Anastomosis
Male
Middle Aged
Sensitivity and Specificity
Tomography Scanners, X-Ray Computed*
Tomography, X-Ray Computed / methods*
Treatment Outcome
Vascular Patency*

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


Previous Document:  Mechanical heart valves in septuagenarians.
Next Document:  Complete surgical repair of Tetralogy of Fallot in adults, is it ever too late?