Assessment of the role of 128 row MDCT in the evaluation of coronary artery bypass grafts patency

El Gerby KM, Amin MI, Amin Mousa MI.

* This article originally appeared in the March 2018 edition of Z.U.M.J.

Background
The recently developed 128 row multidetector CT had made a revolution in coronary artery bypass grafts (CABG) patency evaluation due to high temporal and spatial resolution beside it is being non-invasive.

Subjects and Methods
Fifty patients were enrolled for ECG gated CT of coronary arteries bypass grafts between January 2015 and May 2017. Patients underwent conventional coronary angiography within two weeks of MDCT exam. Administration of beta blocker and nitroglycerin was done prior to CT exam. Breath hold training was mandatory.

Results
Forty-six grafts were arterial and 74 were venous. Thirty-six of the arterial grafts (78.2 %) 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 to 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 at the current days to evaluate the patency and stenosis of coronary artery bypass grafts than the conventional coronary angiography due to its multiple drawbacks.