Diagnostic value of MDCT angiography in assessment of coronary artery bypass graft

Abstract

PurposeTo evaluate the diagnostic value of MDCT angiography in assessment of coronary bypass grafts. We studied 51 patients from April 2008 to October 2011. All patients gave written informed consent, and the study protocol was approved by the Institutional Review Board. 96 grafts including 35 left internal mammary artery (LIMA) grafts, 5 radial artery grafts, and 56 saphenous vein grafts (SVG) were assessed by 64-MDCT and the results were compared with conventional coronary angiography as reference standard. ResultsThe diagnostic value of multi-detector computed tomography for graft occlusion was: 100% sensitivity, 100% specificity, 100% positive predictive value, and 100% negative predictive value. The diagnostic power of multi-detector computed tomography for stenosis of the graft anastomosis was: 100% sensitivity, 96% specificity, 87.5% positive predictive value, and 100% negative predictive value, and 96.4% accuracy. ConclusionMulti-detector computed tomography has become an alternative to coronary angiography to diagnose graft occlusion and stenosis after coronary artery bypass. In addition, multidetector CT has the added advantage over traditional angiographic evaluation of simultaneously allowing evaluation for alternate postoperative complications that may also manifest with chest pain and dyspnea, thereby mimicking recurrent angina.