MDCT of the proximal anastomoses created by nitinol implants in coronary artery bypass grafting: a retrospective two-observer evaluation.

The purpose of this study was to investigate the proximal anastomosis of CABG grafts created by a nitinol aortic connector. After receiving CABG, 33 patients underwent CT examination of the heart. On the same patients, CT was performed on postoperative day 5 (4-row CT, group A) and again 1 year thereafter (16-row CT, group B). Twenty-three ACVB to RCX and 27 ACVB to RCA grafts were included. Every anastomosis was reviewed under different reformations (MIP, MPR and VRT). Interobserver correlation was determined. Five days postoperatively, 48/50 anastomoses were classified as patent. One year postoperatively, 42/50 anastomoses were classified as patent. In both groups, the aortic connector could be visualized with good quality: 1.82+/-1.10 (group A) and 1.93+/-1.22 (group B) for ACVB to RCA, similar results for ACVB to RCX grafts (MPR). Image quality at the aortic connector site did not display a significant difference for any reformation between groups (P>0.05). Within groups, MPR displayed better visualization than MIP and VRT (P<0.05). In the presence of metal implants, CT provides reliable data in evaluation of the proximal anastomosis. Sixteen-row CT does not bring a significant benefit to image quality. MPR displayed the best visualization within both groups.

Visualisation of non-invasive coronary bypass imaging: 4-row vs. 16-row multidetector computed tomography.

UNLABELLED: The purpose of this study was to investigate the image quality of coronary artery bypass graft visualization in 4- and 16-row multidetector CT using multiple imaging reformations. MATERIAL AND METHODS: One hundred sixteen patients underwent CT examination of the heart after receiving CABG. Group A (n=58) received 4-row MDCT; group B (n=58) received 16-row MDCT. Various bypass types such as LITA to LAD and venous grafts to the RCA and RCX were included in the study. A five-point Likert scale was used to grade image quality. Each bypass was reviewed under different imaging reformations: thin slap maximum intensity projection (MIP thin), multiplanar reformation (MPR) and volume rendering technique (VRT). Special attention was paid to the delineation of the distal anastomosis. Interobserver correlation was determined. RESULTS: From 289 bypass grafts examined, 279 (96.54%) were classified as patent and 10 (3.46%) as not patent. Except for the distal anastomosis, 16-row MDCT showed significantly better results for all segments of bypasses. Comparison of reformations within group A and B showed that MIP thin (P<0.05) and VRT (P<0.05) displayed better visualization as compared to MPR. CONCLUSION: Significantly better imaging of all bypass types is possible using 16-row MDCT as compared to 4-row MDCT. Assessment of the distal anastomosis yields no difference between 4- and 16-row technology.