Diagnostic accuracy of 64-slice multidetector computed tomography for selecting coronary artery bypass graft surgery candidates.
OBJECTIVE
The objective of our study was to investigate the diagnostic accuracy of computed tomographic coronary angiography for the selection of candidates for coronary artery bypass graft surgery.


METHODS
Institutional review board approval was obtained. We included 172 patients (mean age, 63 years; 127 men and 45 women) with a suspicion of coronary artery disease who underwent both computed tomographic coronary angiography and conventional coronary angiography. We established eligible criteria for coronary artery bypass graft surgery based on American College of Cardiology/American Heart Association practice guidelines: 3-vessel disease, left main coronary artery disease, and left main coronary artery equivalent disease. Results of computed tomographic coronary angiography and conventional coronary angiography were reviewed retrospectively by 2 radiologists and 2 cardiologists who were unaware of the other examiners' findings. Diagnostic performances of computed tomographic coronary angiography were calculated, with conventional coronary angiography as the reference standard.


RESULTS
The overall sensitivity, specificity, positive predictive value, and negative predictive value of computed tomographic coronary angiography for the selection of coronary artery bypass graft surgery candidates were 85.9%, 96.0%, 93.8%, and 90.7%, respectively. We also obtained high diagnostic performances for 3-vessel disease (sensitivity, 83.1%; specificity, 96.5%; positive predictive value, 92.5%; negative predictive value, 91.6%), left main coronary artery disease (sensitivity, 94.7%; specificity, 96.7%; positive predictive value, 78.3%; negative predictive value, 99.3%), and left main coronary artery equivalent disease (sensitivity, 100%; specificity, 100%; positive predictive value, 100%; negative predictive value, 100%).


CONCLUSIONS
Patients selected as candidates for coronary artery bypass graft surgery with conventional coronary angiography can also be relatively accurately classified by using computed tomographic coronary angiography with 64-slice multidetector computed tomography.
Lee
Hye-Jeong
HJ
Department of Radiology, Research Institute of Radiological Science, Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Kim
Jung-Sun
JS
Kim
Young Jin
YJ
Hur
Jin
J
Yoo
Kyung-Jong
KJ
Choe
Kyu Ok
KO
Choi
Byoung Wook
BW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D056910:Republic of Korea; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed