Evaluation of Venous and Arterial Conduit Patency by 16-Slice Spiral Computed Tomography

Autor: Jawahar L. Mehta, G. Simonetti, Francesco Romeo, A. D’Eliseo, M. Tomassini, M. Sperandio, A. Romagnoli, Eugenio Martuscelli, C. Razzini
Rok vydání: 2004
Předmět:
Male
angiocardiography
heart atrium fibrillation
Image Processing
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Coronary Angiography
Graft Occlusion
Computer-Assisted
Image Processing
Computer-Assisted
Postoperative Period
Prospective Studies
Coronary Artery Bypass
Prospective cohort study
Computed tomography
Tomography
medicine.diagnostic_test
adult
article
Angiography
Graft Occlusion
Vascular
Atrial fibrillation
Arteries
Middle Aged
Spiral computed tomography
aorta stenosis
medicine.anatomical_structure
internal mammary artery
priority journal
Cardiology
diagnostic accuracy
Female
Radiology
Cardiology and Cardiovascular Medicine
prospective study
medicine.medical_specialty
spiral computer assisted tomography
diagnostic imaging
Bypass
Sensitivity and Specificity
Veins
Coronary Restenosis
coronary artery bypass graft
Vascular
Physiology (medical)
Internal medicine
left anterior descending coronary artery
Heart rate
medicine
Humans
human
Mammary Arteries
vascular patency
Aged
business.industry
Unstable angina
Phlebography
medicine.disease
major clinical study
Coronary arteries
Heart failure
Surgery
Spiral Computed
business
Tomography
Spiral Computed
female
graft occlusion
male
sensitivity and specificity
Zdroj: Circulation. 110:3234-3238
ISSN: 1524-4539
0009-7322
DOI: 10.1161/01.cir.0000147277.52036.07
Popis: Background— Computed tomography has been shown to be useful in the evaluation of aortocoronary bypass grafts (CABG). This is the first prospective study to evaluate the accuracy of a new-generation scanner in the detection of patency and significant stenoses (>50% decrease in diameter) of venous and arterial grafts in patients with previous CABG. Methods and Results— In 96 patients (80 males, mean age 62 years) with previous CABG, a multislice computed tomography (MSCT) scan was performed (collimation 16×0.625 mm). Patients with atrial fibrillation, renal failure, severe respiratory disease, severe heart failure, heart rate >70 bpm despite therapy, or unstable angina were excluded. A total of 285 conduits implanted on the native coronary arteries at the time of CABG were evaluated. MSCT data were analyzed by 2 independent radiologists and compared with the results of conventional angiography. Three patients were excluded from analysis. All conduits were judged evaluable in 84 patients. Among these patients, MSCT correctly diagnosed 54 occluded grafts and 4 significant stenoses on the body of the grafts. Of the 17 significant anastomotic lesions, MSCT correctly diagnosed 15. For these 84 patients, diagnostic accuracy was 99%, sensitivity was 97%, and specificity was 100%. When all 93 patients were considered, the sensitivity of MSCT in diagnosing significant stenoses was 96%. Conclusions— MSCT with the new-generation scanner allows for accurate assessment of venous and arterial conduits in patients with previous CABG with a high degree of sensitivity and specificity. Exclusion criteria and radiation exposure remain limitations of the method.
Databáze: OpenAIRE
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