The comparison of the graft patency after coronary artery bypass grafting using coronary angiography and multi-slice computed tomography.
OBJECTIVE
Coronary angiography (CAG) is the gold standard method in evaluating graft patency following coronary artery bypass grafting (CABG), even though there are several kinds of non-invasive methods. Recently developed multi-slice CT (m-CT), having effective scan times up to 0.25 s and multi-row detector array systems, enable rapid imaging of cardiac structures, including coronary arteries during one breath-hold. We compared m-CT with CAG for the evaluation of graft patency following CABG.


METHODS
Forty-two patients having undergone m-CT and CAG within 3 months of CABG were studied. Twenty-three patients underwent conventional CABG and 19 off-pump CABG. A total of 125 grafts were used, including 42 left internal mammary arteries (LIMA), 25 radial arteries (RA), 3 right internal mammary arteries (RIMA) and 55 vein grafts.


RESULTS
CAG showed a 96% (120/125) patency rate (1 LIMA, 2 RA and 2 vein grafts were occluded). m-CT showed a 98% (122/125) correct positive ratio with a sensitivity and specificity of 98 and 100%, respectively. The sensitivity in LIMA, RA, RIMA and vein grafts was 98, 91, 100 and 100%, respectively, with 100% specificity for all. There was an equivocal result in the competitive grafts with native coronary artery that were patent in the CAG, but faint opacification with no significant flow in the m-CT.


CONCLUSIONS
This study showed that m-CT was very simple, useful and accurate in evaluating graft patency during the early post-operative period following CABG, even though there was an equivocal result in the competitive grafts with a native coronary artery.
Yoo
Kyung-Jong
KJ
Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea. kjy@yumc.yonsei.ac.kr
Choi
Donghoon
D
Choi
Byoung Wook
BW
Lim
Sang-Hyun
SH
Chang
Byung-Chul
BC
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency