SUMMARY Twenty four patients with 65 coronary artery bypass grafts were studied by computed tomography and angiography witiin a 10 day period in order to assess graft patency and graft flow. In the assessment of graft patency computed tomography had an accuracy of 93% and in that of graft flow one of 91%. These results indicate that computed tomography is an accurate method for assessing graft patency and flow and is useful in the investigation of certain groups of patients who have had coronary artery bypass graft surgery.Coronary artery bypass grafting is now a common operation in the United Kingdom,' and in the United States is probably the commonest elective operation performed. Information on the patency and function of these grafts is important for assessing current and new surgical techniques and also in managing patients with continuing angina or recurrent angina.The generally accepted technique for assessing graft patency is selective angiography. Recent studies, however, have indicated that computed tomography can be as accurate as angiography in assessing graft patency.2-4 Since computed tomography shows only a small portion of the graft within a single thin transverse section and provides no information about coronary arteries it is not possible to comment on the state of the graft or grafted coronary artery. There is, however, information to suggest that dynamic computed tomography can be used to assess graft flow by studying iodine transit.25 We report our experience in assessing graft patency and flow using this technique.
Patients and methodsTwenty four patients with 65 grafts were studied. Thirteen were investigated because of a recurrence of angina, and 11 consecutive patients who agreed to undergo both angiography and computed tomography were studied in the postoperative period. Computed tomography and angiography were performed within Requests for reprints to Dr C J Foster, Department of Cardiology, Manchester Royal Infirmary, Manchester M13 9WL.
Thirty-eight patients with conditions predisposing to intracardiac thrombus have been studied by computed tomography and cross-sectional echocardiography. Computed tomography identified 22 cases of intracardiac thrombus (13 left ventricular, eight left atrial and one right atrial). Cross-sectional echocardiography identified five of these left ventricular thrombi and the right atrial thrombus, but none of the left atrial thrombi. In addition, measurements of thrombus density on computed tomography identified a significant difference (p less than 0.02) between the density of a new compared with an organized thrombus.
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