ASSESMENT OF CORONARY ARTERY BYPASS GRAFTS BY MULTIDETECTOR CT

Abstract

Background: Multidetector computed tomography (MDCT) had made a revolution in coronary artery bypass grafts (CABG) evaluation due to high temporal and spatial resolution beside it is beingnon invasive and highly effective in assessment of extra coronary manifestations. Objective: To evaluate the feasibility of high-quality multi-detector computed tomography ((MDCT) in assessment of CABG patients in comparison with conventional coronary angiography. Patients and methods: Fifty patients were enrolled for ECG gated CT of coronary arteries bypass grafts between MAY 2020 and September 2020. Patients subjected to conventional coronary angiography within 10days after MDCT exam. at Al-Hussein University Hospital. Administration of beta blocker and nitroglycerin was done prior to CT exam. Breath hold training was mandatory. Results: Forty six grafts were arterial and 74 were venous. Thirty six of the arterial grafts (78.2 %) were patent, 6 (13 %) were significantly narrowed and 4 (8.8 %) were completely occluded. Regarding venous grafts, 52 (70.2 %) of them were patent, 14 (19 %) were significantly narrowed, 8 (10.8 %) were completely occluded. CT angiography compared to the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98% and an accuracy of about 93.6% in the assessment of any type of coronary artery grafts. Conclusion: Multi Detector CT is considered the imaging modality of choice at the current days to evaluate the patency and stenosis of coronary artery bypass grafts than the conventional coronary angiography due to its multiple drawbacks.