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31st Annual Meeting Abstracts: Utility of Fine Cut CT Angiograms after CABG Procedures
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P3. Utility of Fine Cut CT Angiograms after CABG Procedures
J. M. Kratz, J. B. Selby. musc, Charleston, SC,
OBJECTIVE: To determine if CT angiograms are useful tools after CABG surgery.
METHODS: With availability (16 slice-October 2003 and 64 slice-October 2004) fine cut CT angiograms were performed 3 months post CABG on 76 patients. All 76 patients were retrospectively contacted by phone for clinical status and their CT angiograms results reviewed. Clinical interventions precipitated by the CT angiograms were recorded.
RESULTS: Seventy six patients received 191 grafts; sixteen grafts were reported closed. Two grafts reported closed on 16 slice studies were widely patent at cath. In 6 patients care was affected. Five native arteries supplied by closed grafts underwent angioplasty. In 1 patient with subclavian stenosis the IMA was moved to the aorta. Repeat cath of a closed free RIMA graft demonstrated only 20% native artery obstruction. One severely diffusely diseased artery received no further intervention. Six asymptomatic patients declined further intervention. Three of 60 grafts on 16 slice and none of 16 grafts on 64 slice studies were indeterminate. CT angoiograms allowed the surgeon to assess graft patentcy and surgical results. 3D images provided visualization of graft anatomy.
GRAFT PATENCY | RM | PDA | LAD | DX | CX | TOTAL | | # of Grafts | 11 | 33 | 71 | 17 | 59 | 191 | | % Patent | 91% | 89% | 97% | 88% | 90% | 92% | | #Arterial Grafts | 3 | 3 | 64 | 2 | 18 | 90 | | % Patent | 100% | 100% | 100% | 100% | 94% | 99% | | # Venous Grafts | 8 | 30 | 7 | 15 | 41 | 101 | | # Patent | 88% | 87% | 71% | 87% | 85% | 85% |
CONCLUSIONS: While 64 slice scans maybe superior to 16 slice, both provide excellent graft visualization. Information obtained is useful in continuing patient care and improving surgical practice. More aggresive and complex arterial revascularization procedures maybe possible with graphical feedback of surgical results.
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