CT angio for the evaluation of graft patency

Lazzaro, Davide Di; Crusco, Federico

doi:10.21037/jtd.2017.03.111

Cited by 20 publications

(14 citation statements)

References 20 publications

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“…Prospective ECG gating ('step-and-shoot' scan) can deliver radiation at prespecified points of the cardiac cycle, dramatically reducing the overall dose by almost two thirds. 16 wide-detector array imaging or high helical pitch dual-source scanning can capture the entire heart within a single beat to reduce stair-step artefacts. Faster rotation times improve temporal resolution and reduce image degradation at higher heart rates, 17,18 while better iterative reconstruction algorithms further reduce image noise.…”

Section: Discussionmentioning

confidence: 99%

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The value of non-invasive computed tomography coronary angiography in imaging patients with coronary artery bypass grafts

et al. 2020

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Introduction Invasive coronary angiography (ICA) is associated with higher complication rates in patients following coronary artery bypass surgery (CABG). CT coronary angiography (CTCA) has emerged as an attractive alternative. We assessed the impact of CTCA on subsequent ICA. Methods We identified 213 CABG patients undergoing CTCA between 2015 and 2018. In 151 the indication was suspected recurrence of angina. We then identified patients undergoing ICA within 1 year of CTCA. Results CTCA obviated the need for ICA in 115 cases (76%). CTCA was better at identifying targets for percutaneous coronary intervention (PCI) to saphenous vein grafts (SVG’s) than to native vessels (89% vs 47%). 7 out of 10 lesions of “probable” significance by CTCA proved flow-limiting, and 4 out of 13 “indeterminate” lesions. CTCA concordance was 97% for left internal mammary (LIMA) grafts. Conclusion CTCA directed management in a majority of patients without ICA. It identified a cohort of patients likely to be candidates for SVG PCI, but was less effective in identifying PCI targets in the native vessels. CTCA renders invasive LIMA cannulation redundant unless a target lesion is suspected.

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Section: Discussionmentioning

confidence: 99%

“…Faster rotation times improve temporal resolution and reduce image degradation at higher heart rates, 17,18 while better iterative reconstruction algorithms further reduce image noise. 16 Figure 3. Concordance between CTCA and ICA for identifying appropriate PCI target -by vessel type (PCI: percutaneous coronary intervention).…”

Section: Discussionmentioning

confidence: 99%

The value of non-invasive computed tomography coronary angiography in imaging patients with coronary artery bypass grafts

et al. 2020

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“…Recognize artifacts associated with surgical clips as blooming and beam hardening. The nonrevascularized native coronary arteries and those with incomplete revascularization were assessed by segments, following the 17-segment American College of Cardiology/American Heart Association (ACC/AHA) model 17 [25].…”

Section: Bypass Graft Patencymentioning

confidence: 99%

Evaluation of Coronary Artery Bypass by CT Coronary Angiography

Donkol¹,

Mahmoud²,

Elrawy³

2017

Coronary Artery Bypass Graft Surgery

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Coronary computed tomography angiography (CCTA) is an accurate method for graft imaging and assessment than invasive coronary angiography (ICA). CTA has excellent sensitivity and specificity. The chapter describes the role of CTA in evaluation of coronary bypass graft. It covers the appropriate indications for performing CTA after bypass operation, patient preparation, as well as protocol and technique of CTA. The chapter describes the post-examination processing of the images and how to interpret CTA images for detection of graft patency or dysfunction as occlusion, partial thrombosis, poor blood flow, and stealing flow from native artery. According to the American College of Cardiology, the American College of Radiology, and the North American Society for Cardiovascular Imaging, graft patency assessment with CTA is an appropriate approach in symptomatic patients at risk for graft stenosis/occlusion. Cardiac CT can be used to assess the patency of coronary artery bypass graft (CABG) with high diagnostic accuracy compared with ICA and even with a better performance compared to the assessment of native coronaries.

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“…MDCT, compared with invasive coronary angiography, is less expensive, more rapid, less invasive, and may be more accurate for graft imaging than for coronary native arteries because of the relative immobility, the wider luminal diameter, and the lower rate of calcifications [4].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Coronary Artery Bypass Graft by Using Multidetector Computed Tomography Coronary Angiography

Ibrahim¹,

Refaat

Helmy

et al. 2020

Benha Medical Journal

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Background: CABG surgery is the standard care in the treatment of advanced coronary artery disease. Assessment of the status of the grafts after CABG surgery is an important issue. Recently, MDCT has gained rapid acceptance as a diagnostic cardiac imaging modality, allowing assessment of coronary bypass graft patency with high spatial resolution. Aim: Evaluate the role of (MDCT) in assessment of CABG. Patients and methods: In this prospective study, 30 patients after coronary artery bypass graft surgery are included. The 30 patients were examined by ECG gated MDCT coronary angiography in CT unit in radiology department of national heart institute between (October 2018 to April 2019). Results: The study included 30 patients with prior CABG surgery. Mean age was 61 +/-6.9 years with male gender predominance represented 86 % (26 patients). The evaluable grafts were 75 grafts. The most common used grafts were the venous grafts represented 59 %( 44 grafts) while arterial grafts represented 41% (31 grafts).The most common landing site of arterial grafts was LAD (with incidence 84%), while the most common landing site of venous grafts was RCA(with incidence 39%). Conclusion: MDCT coronary angiography is a potentially safe, non-invasive modality in assessment of coronary artery bypass grafts in post-CABG patients.

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CT angio for the evaluation of graft patency

Cited by 20 publications

References 20 publications

The value of non-invasive computed tomography coronary angiography in imaging patients with coronary artery bypass grafts

The value of non-invasive computed tomography coronary angiography in imaging patients with coronary artery bypass grafts

Evaluation of Coronary Artery Bypass by CT Coronary Angiography

Assessment of Coronary Artery Bypass Graft by Using Multidetector Computed Tomography Coronary Angiography

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