Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan.
OBJECTIVE
The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery.


METHODS
Fifteen consecutive children (8 male and 7 female; age 9.2+/-6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8+/-3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard.


RESULTS
CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography.


CONCLUSIONS
In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surgery.
Marini
Davide
D
Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, UFR Necker-Enfants Malades, Paris, France.
Agnoletti
Gabriella
G
Brunelle
Francis
F
Sidi
Daniel
D
Bonnet
Damien
D
Ou
Phalla
P
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002648:Child; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome