Internal thoracic arterial grafts evaluation by multislice CT scan: a preliminary study.
OBJECTIVE
The internal thoracic artery (ITA) has a better long-term patency than saphenous veins, and anastomosis between ITA and the left anterior descending artery (LAD) represents the "gold-standard" of surgical myocardial revascularization. The aim of this study is to evaluate the multidetector multislice CT Scan (MCTS) as a means of postoperative evaluation of ITA coronary artery bypass grafts.


METHODS
Twenty-eight patients having been operated on for coronary artery bypass with ITA during a 6-months period, benefited, 7 days after surgery, from a patency and anastomotic site control of ITA with a MCTS associated with cardiac gating (Light Speed, General Electric, USA).


RESULTS
Internal thoracic artery bypasses are visualized perfectly on all their courses, with possibility of 3D reconstructions, showing the relationship between cardiac cavities and the arterial bypasses. The anastomotic site on the LAD was, in selected cases, perfectly visualized. Sequential bypasses with left ITA are well visualized as well as T or Y right-to-left ITA grafts. However, surgical clips create some image artefacts.


CONCLUSIONS
The postoperative control of ITAs are possible by MCTS with a satisfactory resolution. This makes it possible to check the patency of ITAs, their course on the heart surface, and the location and quality of anastomosis with a noninvasive reproductive method.
Demaria
R G
RG
Department of Cardiovascular Surgery, Arnaud de Villenueve Hospital, Montpellier Teaching Hospital, Montpellier I University, France. roland.demaria@wanadoo.fr
Picichè
M
M
Vernhet
H
H
Battistella
P
P
Rouvière
P
P
Frapier
J-M
JM
Albat
B
B
D000714:Anastomosis, Surgical; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008323:Mammary Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency