RESUMO
BACKGROUNDS: The development of a noninvasive, accurate imaging technique for assessing coronary artery bypass graft patency is of major clinical importance because increasing numbers of patients have undergone coronary artery bypass surgery. The electron beam tomography, by virtue of its rapid data acquisition time and good spatial resolution, may be useful in this regard. The purpose of this study is to determine the accuracy of three-dimensional coronary angiography by electron beam tomography (EBT) in the assessment of patency of coronary artery bypass grafts. METHODS: Twenty-five patients who had undergone coronary artery bypass graft surgery were included. All patients underwent EBT and conventional coronary angiography for the evaluation of the status of bypass grafts. Three dimensional reconstruction of the heart and bypass grafts were performed and compared with selective angiography of the bypass grafts. RESULTS: Fifty-seven saphenous vein grafts (SVG) and 22 left internal mammary artery (LIMA) were evaluated for occlusion or patency. The sensitivity and specificity of EBT in the evaluation of LIMA patency were 80%, 82.4%, respectively. The sensitivity and specificity of EBT in the evaluation of SVG patency were 91.7% and 91.1%, respectively. The sensitivity and specificity of EBT in the evaluation of SVG according to the coronary territory were : 1) SVG to left anterior descending artery 100%, 100%:2) SVG to diagonal branch 100%, 100%:3) SVG to left circumflex artery 100%, 88.9%:4) SVG to right coronary artery 75%, 85.7%. CONCLUSION: Three-dimensional coronary angiography by electron beam tomography is a promising, useful and relatively accurate diagnostic technique for the evaluation of graft patency in patients who had undergone coronary artery bypass graft surgery.
Assuntos
Humanos , Angiografia , Artérias , Angiografia Coronária , Ponte de Artéria Coronária , Vasos Coronários , Coração , Artéria Torácica Interna , Veia Safena , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Transplantes , VirtudesRESUMO
BACKGROUNDS: The development of a noninvasive, accurate imaging technique for assessing coronary artery bypass graft patency is of major clinical importance because increasing numbers of patients have undergone coronary artery bypass surgery. The electron beam tomography, by virtue of its rapid data acquisition time and good spatial resolution, may be useful in this regard. The purpose of this study is to determine the accuracy of three-dimensional coronary angiography by electron beam tomography (EBT) in the assessment of patency of coronary artery bypass grafts. METHODS: Twenty-five patients who had undergone coronary artery bypass graft surgery were included. All patients underwent EBT and conventional coronary angiography for the evaluation of the status of bypass grafts. Three dimensional reconstruction of the heart and bypass grafts were performed and compared with selective angiography of the bypass grafts. RESULTS: Fifty-seven saphenous vein grafts (SVG) and 22 left internal mammary artery (LIMA) were evaluated for occlusion or patency. The sensitivity and specificity of EBT in the evaluation of LIMA patency were 80%, 82.4%, respectively. The sensitivity and specificity of EBT in the evaluation of SVG patency were 91.7% and 91.1%, respectively. The sensitivity and specificity of EBT in the evaluation of SVG according to the coronary territory were : 1) SVG to left anterior descending artery 100%, 100%:2) SVG to diagonal branch 100%, 100%:3) SVG to left circumflex artery 100%, 88.9%:4) SVG to right coronary artery 75%, 85.7%. CONCLUSION: Three-dimensional coronary angiography by electron beam tomography is a promising, useful and relatively accurate diagnostic technique for the evaluation of graft patency in patients who had undergone coronary artery bypass graft surgery.
Assuntos
Humanos , Angiografia , Artérias , Angiografia Coronária , Ponte de Artéria Coronária , Vasos Coronários , Coração , Artéria Torácica Interna , Veia Safena , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Transplantes , VirtudesRESUMO
PURPOSE: To evaluate the efficacy of computed tomography(CT) in detecting pericardial adhesion. MATERIALS AND METHODS: CT of 32 patients with 'redo-valve surgery' was retrospectively evaluated for the location and appearance of their surgically confirmed pericardial adhesion. CT of 20 cases without cardiac or pericardial disease was reviewed as normal control. RESULTS: Nodular increased density at the site of adhesion between the sternum and the right atrium(RA) or ascending aorta(n=10), retrosternal dirty fat(n=10), obliteration of the pericardial fat(n=28), cardiac contour change with or without nodular epicardial fat accumulation(n=10), diffuse pericardial thickening(n=14), and pericardial calcification(n=13) were considered to be important findings. We also noticed an additional findings of beak-like projection of RA appendage(n=13), but was considered less significant because they were also observed in 4 normal subjects. CONCLUSION: CT scan is an effective, simple, and noninvasive method for predicting pericardial adhesion that may be occurred after redo-valve surgery.
Assuntos
Humanos , Estudos Retrospectivos , Esterno , Tomografia Computadorizada por Raios XRESUMO
The surgical management of patients whose pulmonary arteries are discontinuous from the ventricular mass depends in part on adequate visualization and quantification of the pulmonary arteries. Pulmonary vein wedge angiography has proven effective technique in demonstrating the true mediastinal(intrapericardial) pulmonary arteries(when present) when standard anterograde injections do not suffice. Pulmonary vein wedge angiography was performed in 11 patients during cardiac catheterization at Serverance Hospital Yonsei University College of Medicine between June, 1984 and December, 1985. In all the patients, venous angiography gave a more complete, clear picture of the pulmonary arteries. We feel that pulmonary venous wedge angiography often is superior to and at least complements standard angiographic methods of opacifying the pulmonary artries in patients with pulmonary atresia or occluded pulmonary arteries. We recommend it as a routine part of the evaluation of these patients.