Non-invasive coronary bypass graft imaging after multivessel revascularisation.
Non-invasive imaging techniques for the detection of graft patency after multivessel coronary revascularisation may be useful for follow-up after surgery. Forty consecutive asymptomatic patients (38 men, age 59.9+/-1.3 years) who had undergone coronary bypass surgery with at least three grafts were examined by spiral computed tomography or magnetic resonance angiography 24.9+/-0.3 months after surgery, using conventional angiography as reference. In total, 133 grafts (37 internal mammary artery, 96 venous grafts) were analysed. Spiral computed tomography studies were performed with a subsecond scanner; for magnetic resonance angiography, a three-dimensional contrast-enhanced gradient echo technique with ultrashort echo time during breath holding was used. For spiral computed tomography, sensitivities were 76% (internal mammary artery) and 100% (venous graft). This was compared with 100% (internal mammary artery) and 92% (venous graft) assessed by magnetic resonance angiography (P=ns). The positive predictive values were 100% for internal mammary artery and venous graft (spiral computed tomography) and 100% (internal mammary artery), 92% for venous grafts studied by magnetic resonance angiography (P=ns). Both subsecond spiral computed tomography and contrast-enhanced magnetic resonance angiography are highly accurate and relatively non-invasive approaches of assessing coronary graft patency after multivessel revascularisation and have potential for follow-up assessment in the long term.
Engelmann
M G
MG
Medical Department I, Ludwig-Maximilians University, Klinikum Grosshadern, Munich, Germany. mge@lrz.uni-muenchen.de
Knez
A
A
von Smekal
A
A
Wintersperger
B J
BJ
Huehns
T Y
TY
Höfling
B
B
Reiser
M F
MF
Steinbeck
G
G
D003287:Contrast Media; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D006801:Humans; D021621:Imaging, Three-Dimensional; D007387:Internal Mammary-Coronary Artery Anastomosis; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency
D003287:Contrast Media