title: Noninvasive detection of coronary artery bypass graft patency by intravenous electron beam computed tomographic angiography.
abstract: This study evaluates the usefullness of intravenous electron beam computed tomographic angiography (EBA) for the detection of coronary artery bypass graft patency in 43 patients (33 men and 10 women, mean age, 65 years) who had coronary artery bypass graft surgery. EBA was performed a few days before selective bypass graft angiography (SGA). Forty axial cross-sections of angiographic images of the heart were acquired consecutively by an electrocardiographic trigger signal at 40% of the RR interval, which corresponds to the end-systolic phase. EBA data were reconstructed as a three-dimensional shaded surface display of the heart and bypass grafts. Detectability of the patency of bypass gratis was evaluated, taking selective angiographic images of the bypass grafts as a gold standard. One hundred and nine grafts (96%) out of 114 grafts were subjected to evaluation: 37 grafts were left internal mammary artery grafts (LIMA), 7 were right internal mammary artery grafts (RIMA), 6 were gastroepiploic artery grafts (GEA), 7 were free gastroepiploic artery grafts with venous drainage (free-GEA), 7 were radial artery grafts (RAG), and 45 were saphenous vein gratis (SVG). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBA were 98%, 100%, 100%, 91%, and 98%, respectively. EBA sampled at the end-systolic period was determined to be useful for the detection of coronary artery bypass graft patency and occlusion.
authors.affiliation: Division of Cardiology, Cardiovascular Center, Aichi Prefectural Owari Hospital, Ichinomiya, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamakami
authors.forename: Junji
authors.initials: J
authors.lastname: Toyama
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Okamoto
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Matsushita
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Murakami
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogata
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ito
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fukutomi
authors.forename: Naotsuka
authors.initials: N
authors.lastname: Okayama
authors.forename: Makoto
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery; D019074:Epigastric Arteries / Q000637:transplantation; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012501:Saphenous Vein / Q000637:transplantation; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014654:Vascular Patency