Contrast-enhanced cardiac MRI before coronary artery bypass surgery: impact of myocardial scar extent on bypass flow.
The aim of the study was to relate the extent of myocardial late gadolinium enhancement (LGE) in cardiac MRI to intraoperative graft flow in patients undergoing coronary artery bypass graft (CABG) surgery. Thirty-three CAD patients underwent LGE MRI before surgery using an inversion-recovery GRE sequence (turboFLASH). Intraoperative graft flow in Doppler ultrasonography was compared with the scar extent in each coronary vessel territory. One hundred and fourteen grafts were established supplying 86 of the 99 vessel territories. A significant negative correlation was found between scar extent and graft flow (r = -0.4, p < 0.0001). Flow in grafts to territories with no or small subendocardial scar was significantly higher than in grafts to territories with broad nontransmural or transmural scar (75 +/- 39 vs. 38 +/- 26 cc min(-1); p < 0.0001). In summary, the extent of myocardial scar as defined by contrast-enhanced MRI predicts coronary bypass graft flow. Beyond the probability of functional recovery, preoperative MRI might add value to surgery planning by predicting midterm bypass graft patency.
Hunold
Peter
P
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. peter.hunold@uk-essen.de
Massoudy
Parwis
P
Boehm
Claudia
C
Schlosser
Thomas
T
Nassenstein
Kai
K
Knipp
Stephan
S
Eggebrecht
Holger
H
Thielmann
Matthias
M
Erbel
Raimund
R
Jakob
Heinz
H
Barkhausen
Jörg
J
D000368:Aged; D001783:Blood Flow Velocity; D003287:Contrast Media; D001026:Coronary Artery Bypass / Q000379:methods*; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery*; D005260:Female; D019786:Gadolinium DTPA; D006085:Graft Survival; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017682:Myocardial Stunning / Q000175:diagnosis* / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis
D003287:Contrast Media; D019786:Gadolinium DTPA