Effectiveness of MDCT for the Followup of CABG Patients with LIMA to LAD and Saphenous Veins to Others / 대한흉부외과학회지

ABSTRACT

BACKGROUND: There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. MATERIAL NAD METHOD: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. RESULT: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years postoperatively with a median follow-up period of 6.5 years, and mean follow-up peiod of 31.5+/-25.4 months. Mean age was 58.4+/-12.6 years old in men and 61.5+/-17.2 years old in women. 72/80 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was 3.1+/-1.8 grafts. 5 year graft patency rate of each grafts was as followings; 93.1% in LIMA to LAD, 94.9% in vein to diagonals, 92.1% in vein to obtuse marginals, and 79.2% in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting (95.2% vs 78.7~95.0%). CONCLUSION: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.