title: Multi-detector computed tomography in coronary artery bypass graft assessment: a meta-analysis.
abstract: Multi-detector computed tomography (MDCT) has become an alternative to coronary angiography in diagnosis of graft occlusion and stenosis after coronary artery bypass. A literature search was performed for studies comparing angiography to 8-slice, 16-slice, and 64-slice MDCT in the assessment of coronary grafts. In assessing occlusion, 14 studies produced pooled sensitivity of 97.6%, specificity of 98.5%, diagnostic odds ratio of 934.2, area under the curve of 0.996, and Q* of 0.977. Ninety-six percent of all grafts were visualized for occlusion assessment. Beta blockers, symptomatic status, and postoperative period did not significantly affect diagnostic performance. Stenosis assessment produced sensitivity of 88.7% and specificity of 97.4%. Eighty-eight percent of patent grafts could be assessed for stenosis. The diagnostic accuracy of MDCT approaches angiography for diagnosing graft occlusion and stenosis in patients with venous and arterial coronary bypass grafts. Our findings show that cardiac surgeons will need to interpret MDCT images of both native and grafted vessels soon in preparation for primary or re-do coronary bypass grafting procedures.
authors.affiliation: Department of Radiology, City Hospital, Birmingham, United Kingdom.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Jones
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.forename: Nicola
authors.initials: N
authors.lastname: Dunne
authors.forename: Joanne
authors.initials: J
authors.lastname: Kirby
authors.forename: Omer
authors.initials: O
authors.lastname: Aziz
authors.forename: Ahmed
authors.initials: A
authors.lastname: Haq
authors.forename: Christopher
authors.initials: C
authors.lastname: Rao
authors.forename: Vasilis
authors.initials: V
authors.lastname: Constantinides
authors.forename: Sanjay
authors.initials: S
authors.lastname: Purkayastha
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D006801:Humans; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*