A Pictorial Review on the Role of 64-Slice HD MDCT in Detecting Post CABG Cardiothoracic Complications

Abstract

Aims: The aim of this study is to have a pictorial review on the role of 64-slice multi-detector computerized tomography (MDCT) in detecting post coronary artery graft (GABG) cardiothoracic complications. Materials & Methods: During the period from November 2012 to December 2013, a prospective evaluation of 40 patients with suspected post-operative cardiothoracic complications underwent MDCT coronary angiography in our clinical radiology department. Informed consent was obtained from all patients and the study had institutional review board approval. Descriptive statistics were used to analyze the data. Results: There were 35 males and 5 females, their mean age ± (SD) of 57 ± 3.9 years. A total of 60 grafts were available for evaluation. Two patients could not be evaluated due to clip-artifacts and advanced atherosclerotic disease. Eleven patients showed occluded graft (9) at proximal and distal (2) anastomosis. Seven patients showed pericardial effusion and pleural effusion (8). Two patients had chest wall infection with retrosternal extension and associated mediastinal involvement. One patient showed aneurysm at the re-implanted coronary artery after Bentall procedure, another patient had postoperative myocardial infarction, one patient showed dissection of the ascending aorta, one patient pseudoaneurysm of left ventricle, two patients localized pericardial hematoma, two patients pulmonary embolism, and two patients showed pneumonia. All these complications occurred from 1 -60 days from surgery. Conclusion: HD MDCT is an easy non-invasive technique which showed to be effective in diagnosis of most postoperative CABG cardiothoracic complications and is gaining more ground in difficult clinical situations. Keywords

Retrosternal hematoma causing torsade de pointes after coronary artery bypass graft surgery; a case report

“…Hematoma, alone, is an important complication, as it can rarely compress the heart and arteries and may even cause superior vena cava syndrome ( 26 ) and tamponade, which lead to shock and death in the patients ( 27 ). Therefore, diagnosis is essential; previous studies have suggested CT scan as an accurate diagnostic tool for post-CABG epicardial and retrosternal hematoma formation ( 28 , 29 ). We could also detect the details of the developed hematoma by CT scan successfully.…”

“…Hematoma, caused by the leaking of blood from an aneurysmectomy/aneurysmorrhaphy site, is listed among common postoperative complications of CABG; but not as a cause of post-CABG TdP. Hematoma, alone, is an important complication, as it can rarely compress the heart and arteries and may even cause superior vena cava syndrome (26) and tamponade, which lead to shock and death in the patients (27). Therefore, diagnosis is essential; previous studies have suggested CT scan as an accurate diagnostic tool for post-CABG epicardial and retrosternal hematoma formation (28, 29).…”