Non-invasive assessment of coronary artery bypass grafts and native coronary arteries using 64-slice computed tomography: comparison with invasive coronary angiography.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Although the diagnostic accuracy of CT in the non-invasive assessment of coronary arteries and grafts is known to be high, only a few studies have investigated the technique's reliability for the combined assessment of native coronary arteries, grafts, and vessels lying distal to anastomoses. The aim of this study was to evaluate the diagnostic accuracy of 64-slice CT for assessing coronary grafts and native coronary arteries. METHODS: In the study, 64-slice CT was used to evaluate 36 patients who had undergone coronary artery bypass graft surgery and had a clinical indication for angiographic graft assessment. The diagnostic accuracy of CT for identifying significant lesions in grafts and native coronary arteries was determined and compared with that of invasive coronary angiography. RESULTS: Of the 103 grafts studied (49 arterial and 54 venous), 96 (93.2%) could be visualized by angiography and 98 (95.1%) by CT. The sensitivity and specificity of CT for detecting significant lesions in grafts were 100% (30/30) and 97% (64/66), respectively, and the positive predictive value (PPV) and negative predictive value (NPV) were 94% and 100%, respectively. For non-revascularized coronary arteries (258 segments), the sensitivity, specificity, PPV and NPV were 94%, 95%, 80%, and 99%, respectively, and for distal vessels, 86%, 97%, 67%, and 99%, respectively. CONCLUSIONS: The diagnostic accuracy of 64-slice CT for evaluating both coronary grafts and native coronary arteries was high.