TITLE

Can we perform coronary artery bypass grafting on the basis of computed tomographic angiography alone? A comparison with conventional coronary angiography

AUTHOR(S)
Bedi, Harinder Singh; Gill, Jeet Amol Singh; Bakshi, Sandeep Singh
PUB. DATE
April 2008
SOURCE
European Journal of Cardio-Thoracic Surgery;Apr2008, Vol. 33 Issue 4, p633
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objectives: Multislice (64 slice) computed tomography (MSCT) angiography has recently emerged as a potential technique that can evaluate the coronaries in an accurate yet non-invasive manner. It has still not been shown whether the accuracy of the anatomy shown is precise enough to operate on the basis of MSCT alone. The aim of this prospective clinical trial is to compare MSCT to conventional coronary angiography (CCA), and to conclude whether MSCT alone is adequate for proceeding for CABG. Methods: 50 patients with proven severe coronary artery disease (CAD) on CCA for elective CABG underwent MSCT prior to CABG. The MSCT images were compared with CCA and the accuracy, sensitivity and specificity of detecting significant stenosis cross checked. Lesion-by-lesion analysis was made. CCA was used as the reference standard for location and degree of stenosis. Results: An excellent correlation was found between the CCA and MSCT findings. The overall sensitivity, specificity, positive (PPV) and negative (NPV) predictive values for quantitative assessment of stenosis >70% by MSCT compared to CCA were 98.5, 99.1, 82.3 and 99.8%, respectively. Comparing the maximal percent diameter luminal stenosis by MSCT versus CCA, the Pearson''s correlation coefficient between the two modalities was 0.994 (p <0.0001). Bland-Altman analysis demonstrated a mean difference in percent stenosis of 0.05±2.42% (p =0.753). There was no significant correlation between stenosis difference and stenosis severity (Pearson''s correlation coefficient=−0.027, p =0.695). 192 out of 207 (92.8%) of the observations were within ±1.96 SD (4.8 to −4.7% stenosis difference). Conclusions: The improved spatial and temporal resolution of the 64 row scanner provides an excellent correlation of MSCT with CCA. MSCT is a valuable tool in the armamentarium of the cardiac scientist. For the cardiac surgeon performing off pump CABG it helps in precise planning of the procedure and pre-judging the length of the conduit required. On the basis of our findings, in selected patients, we recommend the consideration of MSCT as a sole criteria for proceeding for CABG without CCA.
ACCESSION #
31304683

 

Related Articles

  • Clinical and angiographic follow-up of coronary artery fistula interventions in children: techniques and classification revisited. Thakkar, Bhavesh; Patel, Nehal; Poptani, Vishal; Madan, Tarun; Saluja, Tarandip; Shukla, Anand; Oswal, Nilesh; Bisnoi, Arvind // Cardiology in the Young;Apr2015, Vol. 25 Issue 4, p670 

    Background: Transcatheter closure of coronary artery fistula has emerged as a safe and effective alternative to surgery. However, follow-up angiographic data after closure of the coronary artery fistula is extremely limited. We report our clinical and angiographic follow-up of children who...

  • Coronary angiography enhancement for visualization. Shengxian Tu; Koning, Gerhard; Tuinenburg, Joan C.; Jukema, Wouter; Su Zhang; Yazhu Chen; Reiber, Johan H. C. // International Journal of Cardiovascular Imaging;Oct2009, Vol. 25 Issue 7, p657 

    High quality visualization on X-ray angiograms is of great significance both for the diagnosis of vessel abnormalities and for coronary interventions. Algorithms for improving the visualization of detailed vascular structures without significantly increasing image noise are currently demanded in...

  • Multi-slice computed tomography in coronary artery disease Jones, Catherine M.; Athanasiou, Thanos; Dunne, Nicola; Kirby, Joanne; Attaran, Saina; Chow, Andre; Purkayastha, Sanjay; Darzi, Ara // European Journal of Cardio-Thoracic Surgery;Sep2006, Vol. 30 Issue 3, p443 

    Summary: Multi-slice computed tomography technology is emerging as a realistic investigation in patients with suspected disease in native, stented or grafted coronary arteries. A non-invasive diagnostic tool is desirable as these patients are at high risk for complications of invasive...

  • AN ATTEMPT AT THE ROENTGENOLOGIC VISUALIZATION OF CORONARY BLOOD VESSELS IN MAN. Radner, Stig // Acta Radiologica;Aug2008 Supplement 434, Vol. 49, p43 

    An important segment of the human circulatory system, the coronary vessels, still remains outside the scope of the angiography. P. ROUSTHÖI has demonstrated in animals that these vessels can be opacified from the bulb of the aorta and the present author has confirmed his observations in the...

  • "Accordion effect" in reverse. Critoph, C.; Jam, A.; Robinson, N. // Heart;Aug2008, Vol. 94 Issue 8, p966 

    The article reports on a case where a coronary artery narrowing was seen to resolve completely after the passage of a guiding wire, which served as the "accordion effect" in reverse. The accordion effect or wire effect illustrates the angiographic appearance of a coronary artery that was...

  • Angiographic and Pathologic Correlations in Prinzmetal Variant Angina. Rizzon, Paolo; Rossi, Lino; Calabrese, Pietro; Franchini, Giovanni; DiBiase, Matteo // Angiology;Jun1978, Vol. 29 Issue 6, p486 

    The coronary-arteriographic and pathologic findings in a case of Prinz-metal's angina are reported. Right coronary arteriograms performed in the absence of pain showed only minor stenotic changes, whereas those performed during an anginal attack revealed a spastic occlusion involving almost the...

  • Dual left anterior descending coronary artery. Moreno-Martínez, Francisco L. // Internet Journal of Thoracic & Cardiovascular Surgery;2004, Vol. 7 Issue 1, p53 

    The normal anatomy of coronary arteries is well known but there is a great variety on its origin and distribution. Congenital coronary anomalies are uncommon and the vast majority is diagnosed incidentally during coronary angiogram or necropsy. Isolated coronary anomalies are uncommon diseases...

  • Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Klass, Oliver; Jeltsch, Martin; Feuerlein, Sebastian; Brunner, Horst; Nagel, Hans-Dieter; Walker, Matthew J.; Brambs, Hans-Juergen; Hoffmann, Martin H. K. // European Radiology;Apr2009, Vol. 19 Issue 4, p829 

    To assess image quality and radiation exposure with prospectively gated axial CT coronary angiography (PGA) compared to retrospectively gated helical techniques (RGH). Forty patients with suspected coronary artery disease (CAD) and a stable heart rate below 65 bpm underwent CT coronary...

  • High spatial resolution contrast-enhanced MR angiography of the supraaortic arteries using the quadrature body coil at 3.0T: a feasibility study. Willinek, Winfried A.; Bayer, Thomas; Gieseke, Jürgen; von Falkenhausen, Marcus; Sommer, Torsten; Hoogeveen, Romhild; Wilhelm, Kai; Urbach, Horst; Schild, Hans H.; Gieseke, Jürgen // European Radiology;Mar2007, Vol. 17 Issue 3, p618 

    To examine whether the the increased signal-to-noise (S/N) available at 3.0T would permit the use of the quadrature body coil for high spatial resolution contrast-enhanced (CE) MR angiography (MRA), and whether the large FOV that was used in our routine 1.5T protocol would also be feasible at...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics