MDCT of the proximal anastomoses created by nitinol implants in coronary artery bypass grafting: a retrospective two-observer evaluation

Abstract

The purpose of this study was to investigate the proximal anastomosis of CABG grafts created by a nitinol aortic connector. After receiving CABG, 33 patients underwent CT examination of the heart. On the same patients, CT was performed on postoperative day 5 (4-row CT, group A) and again 1 year thereafter (16-row CT, group B). Twenty-three ACVB to RCX and 27 ACVB to RCA grafts were included. Every anastomosis was reviewed under different reformations (MIP, MPR and VRT). Interobserver correlation was determined. Five days postoperatively, 48/50 anastomoses were classified as patent. One year postoperatively, 42/50 anastomoses were classified as patent. In both groups, the aortic connector could be visualized with good quality: 1.82+/-1.10 (group A) and 1.93+/-1.22 (group B) for ACVB to RCA, similar results for ACVB to RCX grafts (MPR). Image quality at the aortic connector site did not display a significant difference for any reformation between groups (P>0.05). Within groups, MPR displayed better visualization than MIP and VRT (P<0.05). In the presence of metal implants, CT provides reliable data in evaluation of the proximal anastomosis. Sixteen-row CT does not bring a significant benefit to image quality. MPR displayed the best visualization within both groups.

Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis

“…In contrast, 1-year patency rates of 80% to 86% were reported for conventional venous bypass grafts. 19,20 To our knowledge, the longest follow-up studies were those of Kitamura and coworkers 17 (19-month follow-up with a 1-year patency rate of 92.6%) and Khan and associates 21 (12-month patency rate of 84%). These studies, however, said nothing about the degree of stenosis of patent venous grafts.…”

Facilitating coronary artery evaluation in MDCT using a 3D automatic vessel segmentation tool

“…Cone-shaped pointers are used for marking the detected calcifications (left image) [25][26][27][28][29][30][31][32][33]. For evaluation of the generated image dataset, various reformations such as MIP, MPR and VRT in addition to the axial images have been developed and their benefit evaluated [34][35][36]. Though the data acquisition itself can be performed in a highly standardized fashion, evaluation of the acquired dataset very much depends on the experience of the reader.…”

Early and midterm patency of the proximal anastomoses of saphenous vein grafts made with a Symmetry Aortic Connector System

“…20 In this study, early graft patency rate was satisfactory, and midterm occlusion rates did not exceed those reported in the literature for hand-sewn polypropylene sutures. 9,[21][22][23] We speculated that once technical errors, such as graft kinking or inadequate graft angle, were ruled out in the postoperative course, acceptable midterm graft patency could be expected.…”