Assessment of coronary artery bypass grafts by multidetector computed tomography

Abstract

Background Multidetector computed tomography (MDCT) had made a revolution in coronary artery bypass graft (CABG) evaluation owing to high temporal and spatial resolution, besides it being noninvasive and highly effective in assessment of extracoronary manifestations. Objective To evaluate the feasibility of high-quality MDCT in assessment of patients with CABG in comparison with conventional coronary angiography. Patients and methods A total of 50 patients were enrolled for ECG-gated CT of CABGs between May 2020 and September 2020. Patients were subjected to conventional coronary angiography within 10 days after MDCT examination at Al Hussein University Hospital. Administration of beta-blocker and nitroglycerin was done before CT examination. Breath-hold training was mandatory. Results A total of 46 grafts were arterial and 74 were venous. Overall, 36 (78.2%) of the arterial grafts were patent, six (13%) were significantly narrowed, and four (8.8%) were completely occluded. Regarding venous grafts, 52 (70.2%) of them were patent, 14 (19%) were significantly narrowed, and eight (10.8%) were completely occluded. CT angiography compared with the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98%, and an accuracy of about 93.6% in the assessment of any type of coronary artery grafts. Conclusion MDCT is considered the imaging modality of choice nowadays to evaluate the patency and stenosis of CABGs than the conventional coronary angiography owing to its multiple drawbacks.