Accuracy of Spiral Computed Tomography for Identifying Arterial and Venous Coronary Graft Patency

Engelmann, Markus G.; Smekal, Alexander; Knez, Andreas; Kürzinger, Elisabeth; Huehns, Tanya Y.; Höfling, B.; Reiser, Maximilian

doi:10.1016/s0002-9149(97)00423-2

Cited by 58 publications

(19 citation statements)

References 19 publications

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“…In most studies, the accuracy to detect bypass occlusion approached 100%. [211][212][213][214][215][216][217][218][219][220][221][222][223][224][225][226] Clinically, however, it might be reasonable in most cases to not only assess the patency of the bypass graft but also the presence of coronary stenoses in the course of the bypass graft or at the anastomotic site, as well as in the native coronary artery system (Class IIb, Level of Evidence: C). This is more difficult, owing to the smaller caliber of these vessels, the presence of artifacts caused by metal clips, and the often pronounced coronary calcification.…”

Section: Follow-up After Bypass Surgerymentioning

confidence: 99%

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Budoff¹,

Achenbach²,

Blumenthal³

et al. 2006

Circulation

1,234

382

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Section: Follow-up After Bypass Surgerymentioning

confidence: 99%

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Budoff¹,

Achenbach²,

Blumenthal³

et al. 2006

Circulation

1,234

382

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“…Posteriormente fueron varios los grupos de trabajo que investigaron la permeabilidad de los injertos aortocoronarios por TC [27][28][29][30] . En los primeros estudios se concluyó que debido a los artefactos por movimiento respiratorio y latido cardiaco, el estudio de TC únicamente podía dirigirse a valorar la permeabilidad de los injertos aortocoronarios ya que técnicamente existían grandes dificultades para determinar la existencia estenosis en los injertos permeables.…”

Section: Valoración Angiográfica De La Permeabilidad De Injertos Aortunclassified

“…En los primeros estudios se concluyó que debido a los artefactos por movimiento respiratorio y latido cardiaco, el estudio de TC únicamente podía dirigirse a valorar la permeabilidad de los injertos aortocoronarios ya que técnicamente existían grandes dificultades para determinar la existencia estenosis en los injertos permeables. Se ha demostrado que hoy en día la angiografía por TCMC con reconstrucción ECG retrospectiva permite visualizar la luz del vaso y así, desde su introducción en la práctica clínica diaria, han sido numerosos los trabajos realizados con esta técnica diagnóstica dirigidos a analizar los injertos aortocoronarios 29,[31][32][33][34] . Se ha descrito una sensibilidad del 86-97% y una especificidad del 89-100% para deter- minar oclusión de los injertos aortocoronarios [32][33][34][35] , con un valor predictivo negativo en torno a 98% 33,34 (Fig.…”

Section: Valoración Angiográfica De La Permeabilidad De Injertos Aortunclassified

TC multicorte (TCMC) cardiaca: aplicaciones clínicas

Bastarrika

Cano

Becker

et al. 2004

Anales Sis San Navarra

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RESUMENLa introducción de los equipos de TC multicorte y el desarrollo de técnicas de adquisición de imágenes con sincronización electrocardiográfica y reconstrucción retrospectiva han permitido que la TC multicorte cardiaca se pueda considerar hoy en día una técnica no invasiva muy útil para el estudio de la patología cardiaca en la práctica clínica diaria. La valoración de las arterias coronarias es una de las principales aplicaciones clínicas de esta técnica diagnóstica e incluye la detección y cuantificación del calcio coronario, la coronariografía por TC multicorte (estudio de la anatomía coronaria, variantes anatómicas y anomalías del origen y trayecto), la valoración angiográfica de la permeabilidad de injertos aortocoronarios y endoprótesis vasculares y la caracterización de las placas de ateroma. Los nuevos programas de reconstrucción y postprocesamiento permiten obtener, además, parámetros de morfología y contracción miocárdica y función cardiaca. Otras aplicaciones clínicas incluyen la caracterización de masas cardiacas intracavitarias y la valoración del pericardio.Palabras clave. Tomografía computarizada. Corazón. Anatomía. ABSTRACTSince the introduction of last generation multislice MSCT systems and the development of simultaneous electrocardiographic-tracing image acquisition and retrospective reconstruction techniques into clinical routine, cardiac MSCT has been considered a very useful non-invasive technique for the study of cardiac pathology in the daily clinical practice.One of the main clinical applications of this diagnostic technique is the evaluation of the coronary arteries including detection and quantification of coronary calcium, multislice CT coronary angiography (anatomy, anatomical variants and anomalies of the origin and course), the angiographic evaluation of the patency of aortocoronary by-pass grafts and coronary stents, and plaque characterization. The new reconstruction and postprocessing programs allow to obtain, in addition, parameters of myocardial morphology and contraction and cardiac function. Other clinical applications include the characterization of cardiac masses and the evaluation of the pericardium.

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“…A 4 slice spiral CT coronary artery evaluation was significantly affected by the presence of metal clips, cardiac motion, and poor opacification. [1][2][3][4] Although after the introduction of 16 and 64 slice CT, these issues were corrected, 5,6 the analysis of distal anastomosis site was still difficult. Schlosser et al in his study reported 96% sensitivity with a specificity of 95% for the evaluation of bypass grafts using 16 slice CT. 7 However, with the improved spatial and temporal resolution, the utilisation of 64 slice CT scan has brought remarkable improvement in the analysis of grafts especially of the anastamotic site and distal segment evaluation.…”

Section: Introductionmentioning

confidence: 99%

64 slice computed tomography—a novel diagnostic method for evaluation of patients after coronary artery bypass grafts

Gomathi

Nandhini

Radhakrishnan

et al. 2012

Indian Heart Journal

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Objective: Multislice computed tomography (CT) is widely used in analysing the native coronary arteries. The usefulness of 64 slice CT in patients with coronary artery bypass grafts (CABG) is analysed in the present study. Materials and methods:Sixty-five patients (59 [92%] males and 6 [8%] females with the mean age of 59 ± 9.1 years) underwent 64 slice CT and a total of 186 bypass grafts (62 arterial and 124 venous grafts) were analysed using 64 slice CT. Bypass grafts and native vessels with the diameter of >1.5 mm were evaluated for the presence of significant stenosis of >70%. In all patients invasive coronary angiogram was done.Results: On the whole 43 venous grafts and 3 arterial grafts were found to be occluded. Majority of the grafts were occluded at the ostium. It was observed that the 64 slice CT was 90% sensitive and 96% specific for the evaluation of bypass grafts. It had 95% positive predictive value and 93% negative predictive value for predicting the luminal narrowing of grafts. For the assessment of arterial graft, it was 80% sensitive, 100% specific with a positive predictive value of 100% and negative predictive value of 93%. For the evaluation of venous grafts, the sensitivity, specificity, positive, and negative predictive value were 94%, 94%, 93%, and 94%, respectively. Conclusion:We conclude that the 64 slice CT is a highly reliable diagnostic tool with a very high negative predictive value for evaluating patients following CABG.

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Accuracy of Spiral Computed Tomography for Identifying Arterial and Venous Coronary Graft Patency

Cited by 58 publications

References 19 publications

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

TC multicorte (TCMC) cardiaca: aplicaciones clínicas

64 slice computed tomography—a novel diagnostic method for evaluation of patients after coronary artery bypass grafts

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