Diagnostic accuracy of 64-slice multi-detector CT in assessment of coronary artery stenosis.

Objective: To investigate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of noninvasive coronary artery assessment. Methods: A total of 559 patients with suspected coronary artery disease had undergone noninvasive coronary CT angiography. The 78 patients (55 men and 23 women) had consecutively received a 64-slice multi-detector row CT (MDCT) examination, as well as invasive coronary angiography, within the three months period of the study. The coronary CT angiography was retrospectively reviewed by two radiologists. The degree of coronary stenosis was compared with invasive conventional angiography. Results: The coronary CT angiography of 1,032 segments in 78 patients were evaluated. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of coronary CT angiography for the detection of coronary artery stenosis were 71.1%, 98.4%, 89.4%, 94.7%, and 94.0% respectively. Conclusion: Coronary CT angiography using a 64-slice MDCT implies the reliable detection of coronary artery stenoses with high diagnostic accuracy.

Early postoperative coronary angiography result in Off-pump Coronary Artery Bypass (OPCAB) patients.

Objective : The purpose of this study was to evaluate the early results of coronary artery bypass without cardiopulmonary bypass (off-pump coronary artery bypass - OPCAB) at Siriraj Hospital. Patients and methods : From September, 2001 to April 2002, eight selected coronary artery disease patients were operated on using the off-pump coronary artery bypass technique. Operative data were collected and postoperative coronary angiography was studied in all patients before discharge. Results : There were no death and no need to resort to the conventional procedure. Postoperative coronary angiography revealed good patency of all 17 grafts. Postoperative cardiac enzymes were elevated in one patient. Conclusion : The early of OPCAB in this study showed good outcomes. Early postoperative angiography demonstrated excellent anastormoses. This procedure needed fewer blood transfusions than the conventional technique. However, long-term follow up of these procedures should be evaluated.