Diagnostic Accuracy of Coronary CT Angiography in
Patients after Coronary Bypass Surgery: Evaluation
of Grafts and Native Coronary Arteries
Narumol Chaosuwannakit MD*,
Pattarapong Makarawate MD**, Songsak Kiatchoosakun MD**,
Chaiyasit Wongvipaporn MD**, Chusak Kuptarnond MD***
Affiliation :
* Radiology Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
** Cardiology Unit, Internal Medicine Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
*** Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand
Objective : To evaluate the diagnostic accuracy in the assessment of both grafts and native coronary arteries in patients
after coronary artery bypass grafts (CABG) by coronary CT angiography (CCTA) in comparison to invasive conventional
coronary angiography (CCA).
Material and Method: CCTA was performed in 54 symptomatic post-CABG patients. Two independent, blinded observers
assessed all grafts and native coronary arteries for significant stenosis. CCA served as a reference standard. One hundred
seventy two graft segments, 156 distal coronary run-offs, 314 grafted coronary segments, and 18 non-grafted coronary
segments were analyzed.
Results : The diagnostic accuracy of CCTA for exclusion or detection of significant stenosis in venous grafts and non-grafted
segments of native coronary arteries was 100%. Sensitivity, specificity, and positive and negative predictive values were all
100%. Sensitivity, specificity, and positive and negative predictive values to detect significant stenosis were 100%, 98%,
91%, and 100%, respectively, in arterial grafts, 100%, 99%,75%, and 100%, respectively, in distal runoffs, and 100%, 87%,
99%, and 100%, respectively, in grafted segments of native coronary arteries.
Conclusion : Non-invasive coronary CT angiography provides high diagnostic accuracy for evaluation of both bypass grafts
and native coronary arteries, although, CCTA is more effective in evaluation of bypass grafts as compared to heavily calcified
native coronary arteries.
Keywords : Coronary artery bypass surgery, Computed tomography (CT), Coronary angiography, Coronary artery disease
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