Purpose
Coronary artery bypass grafting (CABG) is the standard treatment for advanced coronary artery disease.
It is well known that graft patency is the most important variable that determines the long-term clinical outcome; indeed,
the natural history of CABG involves patency rates of 60% at 10 years for venous grafts and 90% for arterial grafts.
Invasive Coronary Angiography (ICA) remains the gold standard tool for the assessment of CABG patency butmultidetector CT has emerged as an non-invasive important diagnostic tool to evaluate both native coronary vessels...
Methods and Materials
47 patients with a history of bypass graft surgery and at least one IMA (Internal Mammary Artery) graft,
for a total of 108 CABG (66 arterial and 42 venous),
underwent coronary CT angiography using a 640-slices CT scanner with prospective gating and step-and-shot protocol with Adaptive Iterative Dose Reduction (AIDR) system 3D,
from January until September 2012.
Exclusion criteria were previous allergic reaction to iodine contrast medium and renal failure (creatinine ≥ 1.5mg/ dl).
All patients that presented heart rate > 65bpm received,
prior the...
Results
Mean effective dose was 5,7 mSv (range between 3,4 and 11,2mSv).
Image quality was judged excellent (score 1) in 74,5% of CABG,
good (score 2) in 14,7%,
fair (score 3) in 7,8% and low (score 4) in 2,9%.
Inter-rater reliability was excellent (k=0.89).
Conclusion
High image quality and low ionizing radiations effective doses make coronary CT angiography using a 640-slices CT with prospective gating an essential tool in the follow-up of patients underwent a CABG.
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