Cor Vasa 2011, 53(1-2):80-83

64-multislice CT - one-year experience with the detection of early graft occlusion after coronary artery bypass surgery

Petr Kačer^1,*, Michal Smetana¹, Dana Kautznerová², David Hačkajlo³, Jan Pirk¹

¹ Klinika kardiovaskulární chirurgie

² Pracoviště radiodiagnostiky a intervenční radiologie

³ Úsek informační a komunikační, Institut klinické a experimentální medicíny, Praha, Česká republika

Aim: To present one-year experience with the use of 64-multislice computed tomography (CT) to detect early postoperative graft occlusion in patients after coronary artery bypass grafting (CABG) showing early postoperative signs of transient myocardial ischemia.

Method: Standard coronary artery bypass grafting was performed on 1222 patients in our center between November 2005 and March 2007. Of this number, 49 patients showed postoperative signs of transient myocardial ischemia and had 64-multislice CT coronary angiography using a Somatom Sensation 64 system.

Results: In six of the 49 patients, 64-multislice CT revealed occlusion of a graft confirmed by subsequent coronary angiography. While, in three patients, the condition was managed by percutaneous coronary intervention (PCI) of their native vascular bed, the remaining three patients required only conservative therapy. None of these six patients had re-do surgery and had a decrease in left ventricular ejection fraction compared with baseline. There were no deaths.

Conclusion: Postoperative myocardial ischemia and/or graft occlusion deteriorate the long-term prognosis of CABG patients. In CABG patients showing signs of postoperative transient myocardial ischemia, 64-multislice CT may noninvasively detect graft occlusion which can be subsequently managed thus favorably affecting the patient's long-term prognosis. Perioperative ischemia is due to graft occlusion in only a small proportion of cases (12%). The graft occlusion may be asymptomatic. In our view, use of 64-multislice CT in managing postoperative myocardial ischemia following coronary artery bypass grafting is beneficial.

Keywords: 64-multislice CT; CABG; Postoperative myocardial ischemia

Published: January 1, 2011  Show citation