Noninvasive assessment of coronary artery bypass graft patency and flow characteristics by electron-beam tomography

J Invasive Cardiol. 2002 Jan;14(1):19-24.

Abstract

Objective: To evaluate the flow characteristics and accuracy for the detection of patent or occluded coronary artery bypass grafts (CABG) with multi-slice flow study of electron-beam tomography (EBT).

Methods: One hundred and twenty-three patients who had undergone CABG surgery were enrolled in this study. Flow datasets were assessed with time-density curves by EBT. The EBT results were blindly compared with post-operative cardiac catheterizations in 26 patients.

Results: Image quality was adequate to evaluate in 111 patients (90.2%). Flow curves of bypass grafts were technically adequate in 265 of 309 (85.8%) saphenous-vein grafts (SVG) and 35 of 56 (62.5%) internal mammary artery (IMA) grafts (p < 0.05). In comparison to conventional angiographic results, EBT correctly identified 14 of 16 occluded grafts (sensitivity, 87.5%) and 68 of 75 patent grafts (specificity, 90.7%), yielding an accuracy of 90.1%. The intra-graft flows of the IMA and SVG were 4.9 +/- 2.2 ml/min/g and 6.9 +/- 2.8 ml/min/g, respectively (p < 0.001), which was 31.6 +/- 20.4% and 39.4 +/- 21.9% of the ascending aorta's flow (16.7 +/- 5.0 ml/min/g) (p < 0.001).

Conclusion: EBT flow study can be used in the assessment of CABG patency and quantification of intra-graft flow of patent CABG vessels.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Flow Velocity / physiology
  • Coronary Artery Bypass*
  • Female
  • Graft Occlusion, Vascular / diagnostic imaging*
  • Graft Occlusion, Vascular / physiopathology
  • Humans
  • Image Enhancement
  • Male
  • Mammary Arteries / diagnostic imaging
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Vascular Patency / physiology*