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Thorac Cardiovasc Surg 2006; 54(2): 96-101
DOI: 10.1055/s-2005-872861
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Detection of Vein Graft Disease Using 4-Row Computed Tomography. Evaluation of Coronary Bypass Graft Patency and Correlation with the Ca-Score

T. Wittlinger1 , I. Martinovic2 , F. Bakhtiary1 , F. Oezaslan1 , A. Moritz1 , K. Ehrhard3
  • 1Department of Thoracic and Cardiovascular Surgery, University Hospital, Frankfurt/Main, Germany
  • 2Department of Heart Surgery, University Hospital, Marburg, Germany
  • 3Department of Radiology, University of Mainz, Mainz, Germany
Further Information

Publication History

Received March 3, 2005

Publication Date:
15 March 2006 (online)

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Abstract

Background: Multi-row computed tomography (MDCT) is a promising non-invasive technique and capable of rapid imaging of cardiac structures, including coronary arteries and bypass grafts during a single held breath. In this study, we evaluated coronary artery bypass graft (CABG) patency by comparing 4-slice computed tomography with conventional contrast angiography. One disadvantage of MDCT is the limited diagnostic accuracy with + increased calcification of the grafts. Therefore, the correlation between Ca-grading and diagnostic accuracy was examined. Methods: We examined 30 patients with 104 bypass grafts with a 4-row MDCT scanner. On the basis of the Ca-score, patients were divided into 3 groups. Results: It was possible to assess the exact degree of stenosis in 25 of 32 > 50 % stenoses with 4-row MDCT, 7 stenoses were underestimated. All occlusions in 21 patients were identified correctly, 33 graft segments were underestimated in MDCT, of which 28 were in the group with a Ca-score of > 800. Conclusions: MDCT allows non-invasive angiographic evaluation of coronary bypass grafts with a high diagnostic accuracy. However, the method strongly depends on the degree of vascular calcification and underrates the degree of stenosis subject to the Ca-score. This is a distinct limitation in distal vascular segments of small calibre which cannot be validly displayed. In patients with low or moderate Ca-score values, MDCT coronary angiography is promising new technique with a high diagnostic accuracy for the detection of graft stenosis or occlusions.

Key words

Multi-row computed tomography - coronary bypass grafts - coronary artery disease - coronary angiography - calcium-score

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Dr. T. Wittlinger

Department of Thoracic and Cardiovascular Surgery
University Hospital

Theodor-Stern-Kai 7

60590 Frankfurt/Main

Germany

Fax: + 49 6 73 26 53 70

Email: thomaswittlinger@t-online.de