Noninvasive midterm follow-up of radial artery bypass grafts with 16-slice computed tomography.
BACKGROUND
The standard invasive procedure to evaluate graft patency is selective coronary angiography. The recent introduction of a new generation of multidetector row computed tomography made possible the noninvasive study of grafts with excellent results in terms of visualization and resolution. We used computed tomography to study all patients with a radial artery graft operated on in 2002.


METHODS
Between April and October 2005, we reviewed all patients operated on by coronary artery bypass grafting at our institution between January and December 2002. A total of 62 patients received a radial artery graft. Of these, 22 were lost at the time of follow-up. The other 40 patients were enrolled for a multidetector row computed tomography study. Demographic and instrumental data were collected for all the patients. A total number of 145 grafts were studied, with complete and excellent visualization.


RESULTS
The scans revealed a 97.77% (44 of 45) patency rate for left internal mammary arteries, 90.57% (48 of 53) for vein grafts, and 73.91% (34 of 46) for radial arteries (mammary artery plus vein grafts versus radial artery patency, p < 0.001). If analyzed for target vessel, we found the poorest result of radial grafts when placed on the right coronary artery (40% [2 of 5] patency rate).


CONCLUSIONS
Noninvasive control of previously bypassed patients is feasible, with no discomfort for them and excellent visualization of grafts. The use of the radial artery as a conduit for bypass graft can be achieved with good results, after a careful choice of the target vessel.
Di Lazzaro
Davide
D
Department of Cardiac Surgery, Azienda Ospedaliera di Perugia, Perugia, Italy. davide.dilazzaro@ospedale.perugia.it
Ragni
Temistocle
T
Di Manici
Gino
G
Bardelli
Giuliana
G
Da Col
Uberto
U
Grasselli
Francesco
F
Antoniella
Amedeo
A
Papa
Walter
W
Crusco
Federico
F
Giovagnoni
Andrea
A
D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000627:therapeutic use; D017534:Radial Artery / Q000637:transplantation*; D020858:Tissue and Organ Harvesting; D036542:Tomography, Spiral Computed; D014654:Vascular Patency; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents; D005996:Nitroglycerin