Investigation of aortocoronary artery bypass grafts by multislice spiral computed tomography with electrocardiographic-gated image reconstruction

Abstract

X-ray coronary angiography, the reference standard for investigation of coronary artery bypass grafts, is an invasive and costly procedure that is not risk free. The development of rapid and reliable noninvasive imaging procedures would therefore be desirable. Evaluation of coronary bypass patients with computed tomography (CT) was first reported in 1980. 1 Brundage B.H. Lipton M.J. Herfkens R.J. Berninger W.H. Redington R.W. Chatterjee K. Carlsson E. Non-invasive assessment of coronary artery bypass grafts by computed tomography. A preliminary report. Circulation. 1980; 61: 826-831 Crossref PubMed Scopus (99) Google Scholar In the following years, a number of studies described the application of conventional CT and electron beam tomography for investigation of bypass grafts. 2 Kahl F.R. Wolfman N.T. Watts L.E. Evaluation of aortocoronary bypass graft status by computed tomography. Am J Cardiol. 1980; 48: 304-310 Abstract Full Text PDF Scopus (15) Google Scholar , 3 McCay C.R. Brundage B.H. Ullyot D.J. Turley K. Lipton M.J. Ebert P.A. Evaluation of early postoperative coronary artery bypass graft patency by contrast-enhanced computed tomography. J Am Coll Cardiol. 1980; 2: 312-317 Abstract Full Text PDF Scopus (34) Google Scholar , 4 Foster C.J. Sekiya T. Brownlee W.C. Isherwood I. Computed tomographic assessment of coronary artery bypass grafts. Br Heart J. 1980; 52: 24-29 Crossref Scopus (11) Google Scholar , 5 Daniel W.G. Döhring W. Stender H.S. Lichtlen P.R. Value and limitations of computed tomography in assessing aortocoronary bypass graft patency. Circulation. 1980; 67: 826-831 Google Scholar , 6 Tello R. Costello P. Ecker C. Hartnell G. Spiral CT evaluation of coronary artery bypass graft patency. J Comput Assist Tomogr. 1980; 17: 253-259 Crossref Scopus (59) Google Scholar , 7 Engelmann M.G. von Smekal A. Knez A. Kürzinger E. Huehns T.Y. Höfling B. Reiser M.F. Accuracy of spiral computed tomography for identifying arterial and venous coronary graft patency. Am J Cardiol. 1980; 80: 569-574 Abstract Full Text Full Text PDF Scopus (55) Google Scholar , 8 Stanford W. Brundage B.H. MacMillan R. Chomka E.V. Bateman T.M. Eldridge W.J. Lipton M.J. White C.W. Wilson R.F. Johnson M.R. Marcus M.L. Sensitivity and specificity of assessing coronary bypass graft patency with ultrafast computed tomography Results of a multicenter study. J Am Coll Cardiol. 1980; 12: 1-7 Abstract Full Text PDF Scopus (82) Google Scholar , 9 Knez A. von Smekal A. Haberl R. Spiegl F. Reichart B. Reiser M.F. Steinbeck G. Significance of ultrafast computed tomography in the assessment of coronary bypass graft patency. Z Kardiol. 1980; 85: 629-634 Google Scholar , 10 Achenbach S. Moshage W. Ropers D. Nossen J. Bachmann K. Noninvasive, three-dimensional visualization of coronary artery bypass grafts by electron beam tomography. Am J Cardiol. 1980; 79: 856-861 Abstract Full Text Full Text PDF Scopus (122) Google Scholar However, due to cardiac and respiration artifacts, conventional CT was restricted to assessment of bypass graft patency and the detection of stenoses in patent bypass grafts was not considered possible. Electron beam tomography is not widely available. Recently, contrast-enhanced multislice spiral CT (MSCT) with retrospective electrocardiographic gating has been shown to permit visualization of the coronary artery lumen. 11 Ohnesorge B. Flohr T. Becker C. Kopp A.F. Schoepf U.J. Baum U. Knez A. Klingenbeck-Regn K. Reisser M.F. Cardiac imaging by means of electrocardiographically gated multisection spiral CT Initial experience. Radiology. 1980; 217: 564-571 Crossref Scopus (454) Google Scholar , 12 Achenbach S. Ulzheimer S. Baum U. Kachelriess M. Ropers D. Giesler T. Bautz W. Daniel W.G. Kalender W.A. Moshage W. Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. Circulation. 1980; 102: 2823-2828 Crossref Scopus (438) Google Scholar We therefore performed a prospective comparison of MSCT to invasive coronary angiography in a group of 65 patients after coronary artery bypass surgery to evaluate the method’s accuracy to detect bypass graft occlusion and stenosis.