OBJECTIVES: We sought to evaluate the contribution of noninvasive dual-source computed tomography angiography (CTA) in the comprehensive assessment of symptomatic patients after coronary artery bypass grafting (CABG). BACKGROUND: Assessment of bypass grafts and distal runoffs by invasive coronary angiography is cumbersome and often requires extra procedure time, contrast load, and radiation exposure. METHODS: Dual-source CTA was performed in 52 (41 men, mean age 66.6 +/- 13.2 years) symptomatic post-CABG patients scheduled for invasive coronary angiography. No oral or intravenous beta blockers or sedation were administered before the scan. Mean interval between CABG surgery and CTA was 9.6 +/- 7.2 (range 0 to 20) years. Mean heart rate during scanning was 64.5 +/- 13.2 (range 48 to 92) beats/min. Seventy-five percent of patients had both arterial and venous grafts. A total of 152 graft segments and 142 distal runoffs vessels were analyzed. Native coronary segments were divided into nongrafted (n = 118) and grafted segments (n = 289). A significant stenosis was defined as >or=50% lumen diameter reduction, and quantitative coronary angiography served as reference standard. RESULTS: The diagnostic accuracy of CTA for the detection or exclusion of significant stenosis in arterial and venous grafts on a segment-by-segment analysis was 100%. Sensitivity, specificity, positive predictive value, and negative predictive value to detect significant stenosis were 95% (95% confidence interval [CI]: 73% to 100%), 100% (95% CI: 96% to 100%), 100% (95% CI: 79% to 100%), 99% (95% CI: 95% to 100%) in distal runoffs respectively; 100% (95% CI: 97% to 100%), 96% (95% CI: 90% to 98%), 97% (95% CI: 93% to 99%), 100% (95% CI: 95% to 100%) in grafted native coronary arteries respectively; and 97% (95% CI: 83% to 100%), 92% (95% CI: 83% to 96%), 83% (95% CI: 67% to 92%), 99% (95% CI: 92% to 100%) in nongrafted native coronary arteries, respectively. CONCLUSIONS: Noninvasive CTA is successful for evaluating bypass grafts in symptomatic post-CABG patients, whereas invasive coronary angiography is still required for the assessment of significant stenosis in distal runoffs and native coronary arteries.
OBJECTIVES: We sought to evaluate the contribution of noninvasive dual-source computed tomography angiography (CTA) in the comprehensive assessment of symptomatic patients after coronary artery bypass grafting (CABG). BACKGROUND: Assessment of bypass grafts and distal runoffs by invasive coronary angiography is cumbersome and often requires extra procedure time, contrast load, and radiation exposure. METHODS: Dual-source CTA was performed in 52 (41 men, mean age 66.6 +/- 13.2 years) symptomatic post-CABG patients scheduled for invasive coronary angiography. No oral or intravenous beta blockers or sedation were administered before the scan. Mean interval between CABG surgery and CTA was 9.6 +/- 7.2 (range 0 to 20) years. Mean heart rate during scanning was 64.5 +/- 13.2 (range 48 to 92) beats/min. Seventy-five percent of patients had both arterial and venous grafts. A total of 152 graft segments and 142 distal runoffs vessels were analyzed. Native coronary segments were divided into nongrafted (n = 118) and grafted segments (n = 289). A significant stenosis was defined as >or=50% lumen diameter reduction, and quantitative coronary angiography served as reference standard. RESULTS: The diagnostic accuracy of CTA for the detection or exclusion of significant stenosis in arterial and venous grafts on a segment-by-segment analysis was 100%. Sensitivity, specificity, positive predictive value, and negative predictive value to detect significant stenosis were 95% (95% confidence interval [CI]: 73% to 100%), 100% (95% CI: 96% to 100%), 100% (95% CI: 79% to 100%), 99% (95% CI: 95% to 100%) in distal runoffs respectively; 100% (95% CI: 97% to 100%), 96% (95% CI: 90% to 98%), 97% (95% CI: 93% to 99%), 100% (95% CI: 95% to 100%) in grafted native coronary arteries respectively; and 97% (95% CI: 83% to 100%), 92% (95% CI: 83% to 96%), 83% (95% CI: 67% to 92%), 99% (95% CI: 92% to 100%) in nongrafted native coronary arteries, respectively. CONCLUSIONS: Noninvasive CTA is successful for evaluating bypass grafts in symptomatic post-CABG patients, whereas invasive coronary angiography is still required for the assessment of significant stenosis in distal runoffs and native coronary arteries.
Authors: E di Cesare; I Carbone; A Carriero; M Centonze; F De Cobelli; R De Rosa; P Di Renzi; A Esposito; R Faletti; R Fattori; M Francone; A Giovagnoni; L La Grutta; G Ligabue; L Lovato; R Marano; M Midiri; L Natale; A Romagnoli; V Russo; F Sardanelli; F Cademartiri Journal: Radiol Med Date: 2012-04-01 Impact factor: 3.469
Authors: Ivar Risnes; Michael Abdelnoor; Geir Ulimoen; Stein Erik Rynning; Terje Veel; Jan L Svennevig; Runar Lundblad; Arne Borthne Journal: Int Wound J Date: 2012-12-12 Impact factor: 3.315
Authors: Gabor G Toth; Bernard De Bruyne; Petr Kala; Flavio L Ribichini; Filip Casselman; Ruben Ramos; Zsolt Piroth; Stephane Fournier; Carlos Van Mieghem; Martin Penicka; Martin Mates; Frank Van Praet; Ivan Degriek; Emanuele Barbato Journal: J Cardiovasc Transl Res Date: 2018-07-19 Impact factor: 4.132
Authors: Maksymilian P Opolski; Won-Keun Kim; Christoph Liebetrau; Claudia Walther; Johannes Blumenstein; Luise Gaede; Jörg Kempfert; Arnaud Van Linden; Thomas Walther; Christian W Hamm; Helge Möllmann Journal: Clin Res Cardiol Date: 2015-01-06 Impact factor: 5.460