Cardiac computed tomography in the evaluation of left anterior descending coronary artery with vein patch reconstruction.
OBJECTIVE
This study evaluated the morphological and functional results of surgical reconstruction of the left anterior descending (LAD) coronary artery with an autologous vein patch, associated with left internal mammary artery (LIMA) grafting onto the patch.


METHODS
Cardiac computed tomography (CT) images were assessed in terms of functional and morphological parameters. Function was evaluated by assessing patency at 36 months of the reconstructed LAD (based on the attenuation of the native vessel distal to the anastomosis). Morphology was evaluated by studying vein-patch diameters, profiles and margins, shape and structure to categorise the patches into three groups (A, B, C). Within 1 month of CT, all patients underwent functional testing (bicycle ergometry).


RESULTS
CT imaging correctly depicted the LAD graft, revealing it to be fully patent in all cases. On the basis of our morphological classification, 21 patients were classed as group A, two as group B and two as group C. At bicycle ergometry, 23 patients were negative and two were positive. Group C patients had the worst functional results.


CONCLUSIONS
Cardiac CT allowed adequate evaluation of the LAD graft patency and morphology, and in consideration of its noninvasive nature, it may become the imaging tool of choice for evaluating extended LAD reconstruction.
Dipartimento di Radiologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. fusaro341@hotmail.com
M
M
Fusaro
N
N
Faccioli
E
E
Calderon
F
F
Santini
A
A
Palumbo
G
G
Morana
F
F
Cademartiri
R Pozzi
RP
Mucelli
D017023:Coronary Angiography / Q000379:methods*; D023903:Coronary Restenosis / Q000175:diagnosis; D003331:Coronary Vessels / Q000601:surgery*; D005080:Exercise Test / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008323:Mammary Arteries / Q000637:transplantation*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency