SPIRAL CT AND CT-ANGIOGRAPHY AFTER CORONARY-BYPASS SURGERY

Aim: Evaluation of spiral-CT and CT-angiography for imaging of venous and arterial coronary bypass grafts during the early postoperative period. Patients and methods: In 198 patients suffering from coronary heart disease, 583 aortocoronary venous grafts (ACVG), 70 arterial grafts and 24 jumped grafts were investigated 9-15 days following coronary surgery. In 57 patients the results were compared to arterial DSA and reconstructive CT-angiography. Results: At arterial DSA 93% of ACVG and 100% of arterial grafts were patent. Spiral-CT demonstrated 104 of 105 ACVG (99%) and 20 of 29 arterial grafts (69%) correct patent. All occluded ACVG (n = 8) were detected. 90% of ACVG but only 32% of arterial grafts were visualised completely over long segments. Imaging of jumped grafts was insufficient. In CT-angiography artificial vessel stenoses impaired correct visualisation of graft morphology. Conclusions: Spiral-CT allows sufficient differentiation of patent and obstructed ACVG during the early postoperative period. Diagnostic of arterial grafts is of lower accuracy. For CT angiography of venous and arterial coronary grafts further improvements are necessary.