JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2004; 44:1224-1229, doi:10.1016/j.jacc.2003.09.075
© 2004 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Schlosser, T.
Right arrow Articles by Barkhausen, J.o.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schlosser, T.
Right arrow Articles by Barkhausen, J.o.

NONINVASIVE CORONARY IMAGING

Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography

Thomas Schlosser, MD*, Thomas Konorza, MD{dagger}, Peter Hunold, MD*, Hilmar Kühl, MD*, Axel Schmermund, MD{dagger} and J.örg Barkhausen, MD*,*

* Department of Diagnostic and Interventional Radiology
{dagger} Department of Cardiology, University Hospital, Essen, Germany

Manuscript received June 24, 2003; revised manuscript received August 26, 2003, accepted September 9, 2003.

* Reprint requests and correspondence: Dr. Jörg Barkhausen, Department of Diagnostic and Interventional Radiology, University Hospital, Hufelandstr. 55, 45122 Essen, Germany (Email: joerg.barkhausen{at}uni-essen.de).

OBJECTIVES: The aim of this study was to evaluate the diagnostic accuracy of a 16-detector row computed tomography (CT) scanner for the assessment of coronary artery bypass grafts.

BACKGROUND: A new generation of multislice spiral CT scanners, equipped with more and thinner detector rows, allows for reliable noninvasive detection of obstructive coronary artery disease.

METHODS: The study included 51 consecutive patients. Three patients had to be excluded from the study due to arrhythmias or fast heart rates despite beta-blockade. A total of 48 patients with 131 coronary artery bypass grafts (internal mammary artery, n = 40; venous grafts, n = 91) were examined by computed tomography angiography (CTA) and by invasive coronary angiography (ICA) using a 16-detector row CT scanner. For cardiac protocols, only the 12 inner detector rings are applied. All CT examinations were performed with retrospective electrocardiogram gating at a mean heart rate of 64 ± 5 beats/min; 120 ml of Xenetix 300 (Guerbert GmbH, Sulzbach, Germany) were continuously injected. The bypass graft patency and the presence of stenoses as well as the proximal and distal anastomoses were evaluated by two experienced readers.

RESULTS: All bypass grafts and 74% of the distal bypass anastomoses could be visualized by CTA; 21 bypass graft occlusions and 1 significant stenosis were detected by CTA and confirmed by ICA. Five false positive and one false negative finding resulted in a sensitivity of 96%, a specificity of 95%, a positive predictive value of 81%, and a negative predictive value of 99%.

CONCLUSIONS: Sixteen-detector row CT scanner technology allows for the reliable visualization of coronary bypass grafts. Dysfunctional bypass grafts can be detected with high diagnostic accuracy. This technology can be used as a noninvasive test for patients with suspected graft dysfunction.

Abbreviations and Acronyms
  CT = computed tomography
  CTA = computed tomography angiography
  EBCT = electron beam computed tomography
  HR = heart rate
  ICA = invasive coronary angiography
  IMA = internal mammary artery
  LAD = left anterior descending coronary artery
  LCX = circumflex coronary artery
  MRI = magnetic resonance imaging
  MSCT = multislice spiral computed tomography
  NPV = negative predictive value
  PPV = positive predictive value
  RCA = right coronary artery




This article has been cited by other articles:


Home page
 CirculationHome page
D. A. Bluemke, S. Achenbach, M. Budoff, T. C. Gerber, B. Gersh, L. D. Hillis, W. G. Hundley, W. J. Manning, B. F. Printz, M. Stuber, et al.
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young
Circulation, July 29, 2008; 118(5): 586 - 606.
[Full Text] [PDF]

Home page
 HeartHome page
W T Roberts, J J Bax, and L C Davies
Cardiac CT and CT coronary angiography: technology and application
Heart, June 1, 2008; 94(6): 781 - 792.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
M. Hamon, O. Lepage, P. Malagutti, J. W. Riddell, R. Morello, D. Agostini, and M. Hamon
Diagnostic Performance of 16- and 64-Section Spiral CT for Coronary Artery Bypass Graft Assessment: Meta-Analysis
Radiology, June 1, 2008; 247(3): 679 - 686.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. R. Kamdar, T. A. Meadows, E. E. Roselli, E. Z. Gorodeski, R. J. Curtin, J. F. Sabik, P. Schoenhagen, R. D. White, B. W. Lytle, S. D. Flamm, et al.
Multidetector Computed Tomographic Angiography in Planning of Reoperative Cardiothoracic Surgery
Ann. Thorac. Surg., April 1, 2008; 85(4): 1239 - 1245.
[Abstract] [Full Text] [PDF]

Home page
 J. Nucl. Med. Technol.Home page
S. Prat-Gonzalez, J. Sanz, and M. J. Garcia
Cardiac CT: Indications and Limitations
J. Nucl. Med. Technol., March 1, 2008; 36(1): 18 - 24.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
F. J. Rybicki, T. Sheth, and F. Y. Chen
Cardiac Surgical Imaging
Card. Surg. Adult, January 1, 2008; 3(2008): 179 - 198.
[Full Text]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. R. Simon, H. Baraki, J. Weidemann, W. Harringer, M. Galanski, and A. Haverich
High-resolution 64-slice helical-computer-assisted-tomographical-angiography as a diagnostic tool before CABG surgery: the dawn of a new era?
Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 896 - 901.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Radiol.Home page
N I Stauder, B Klumpp, H Stauder, G Blumenstock, M Fenchel, A Kuttner, C D Claussen, and S Miller
Assessment of coronary artery bypass grafts by magnetic resonance imaging
Br. J. Radiol., December 1, 2007; 80(960): 975 - 983.
[Abstract] [Full Text] [PDF]

Home page
 Vasc MedHome page
C. M. Kramer, M. J. Budoff, Z. A. Fayad, V. A. Ferrari, C. Goldman, J. R. Lesser, E. T. Martin, S. Rajagopalan, J. P. Reilly, G. P. Rodgers, et al.
ACCF/AHA 2007 Clinical Competence Statement on vascular imaging with computed tomography and magnetic resonance
Vascular Medicine, November 1, 2007; 12(4): 359 - 378.
[PDF]

Home page
 J Am Coll CardiolHome page
C. M. Kramer, M. J. Budoff, Z. A. Fayad, V. A. Ferrari, C. Goldman, J. R. Lesser, E. T. Martin, S. Rajagopalan, J. P. Reilly, G. P. Rodgers, et al.
ACCF/AHA 2007 Clinical Competence Statement on Vascular Imaging With Computed Tomography and Magnetic Resonance: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training Developed in Collaboration With the Society of Atherosclerosis Imaging and Prevention, the Society for Cardiovascular Angiography and Interventions, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society for Vascular Medicine and Biology
J. Am. Coll. Cardiol., September 11, 2007; 50(11): 1097 - 1114.
[Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
G. M. Feuchtner, T. Schachner, J. Bonatti, G. J. Friedrich, P. Soegner, A. Klauser, and D. z. Nedden
Diagnostic Performance of 64-Slice Computed Tomography in Evaluation of Coronary Artery Bypass Grafts
Am. J. Roentgenol., September 1, 2007; 189(3): 574 - 580.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
P. Malagutti, K. Nieman, W. B. Meijboom, C. A.G. van Mieghem, F. Pugliese, F. Cademartiri, N. R. Mollet, E. Boersma, P. P. de Jaegere, and P. J. de Feyter
Use of 64-slice CT in symptomatic patients after coronary bypass surgery: evaluation of grafts and coronary arteries
Eur. Heart J., August 1, 2007; 28(15): 1879 - 1885.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
J. Mueller, J. Jeudy, R. Poston, and C. S. White
Cardiac CT Angiography After Coronary Bypass Surgery: Prevalence of Incidental Findings
Am. J. Roentgenol., August 1, 2007; 189(2): 414 - 419.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Andreini, G. Pontone, G. Ballerini, E. Bertella, E. Nobili, A. Parolari, and M. Pepi
Bypass Graft and Native Postanastomotic Coronary Artery Patency: Assessment With Computed Tomography
Ann. Thorac. Surg., May 1, 2007; 83(5): 1672 - 1678.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Schachner, G. M. Feuchtner, J. Bonatti, N. Bonaros, A. Oehlinger, E. Gassner, O. Pachinger, and G. Friedrich
Evaluation of Robotic Coronary Surgery With Intraoperative Graft Angiography and Postoperative Multislice Computed Tomography
Ann. Thorac. Surg., April 1, 2007; 83(4): 1361 - 1367.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. F. Di Carli and R. Hachamovitch
New Technology for Noninvasive Evaluation of Coronary Artery Disease
Circulation, March 20, 2007; 115(11): 1464 - 1480.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
B. S. Lewis and D. A. Halon
Integrating Multidetector Computed Tomography Into Clinical Practice: Computed Tomography Scanning Shows its Metal
J. Am. Coll. Cardiol., March 6, 2007; 49(9): 960 - 962.
[Full Text] [PDF]

Home page
 HeartHome page
J. M Schussler and P. A Grayburn
Non-invasive coronary angiography using multislice computed tomography
Heart, March 1, 2007; 93(3): 290 - 297.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
G. Muhlenbruch, A. H. Mahnken, M. Das, R. Blindt, C. Hohl, J. E. Wildberger, R. W. Gunther, H. P. Kuhl, and R. Koos
Evaluation of Aortocoronary Bypass Stents with Cardiac MDCT Compared with Conventional Catheter Angiography
Am. J. Roentgenol., February 1, 2007; 188(2): 361 - 369.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. M. Jones, T. Athanasiou, N. Dunne, J. Kirby, O. Aziz, A. Haq, C. Rao, V. Constantinides, S. Purkayastha, and A. Darzi
Multi-Detector Computed Tomography in Coronary Artery Bypass Graft Assessment: A Meta-Analysis
Ann. Thorac. Surg., January 1, 2007; 83(1): 341 - 348.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
D. Ropers, F.-K. Pohle, A. Kuettner, T. Pflederer, K. Anders, W. G. Daniel, W. Bautz, U. Baum, and S. Achenbach
Diagnostic Accuracy of Noninvasive Coronary Angiography in Patients After Bypass Surgery Using 64-Slice Spiral Computed Tomography With 330-ms Gantry Rotation
Circulation, November 28, 2006; 114(22): 2334 - 2341.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. Achenbach
Computed Tomography Coronary Angiography
J. Am. Coll. Cardiol., November 21, 2006; 48(10): 1919 - 1928.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. J. Budoff, S. Achenbach, R. S. Blumenthal, J. J. Carr, J. G. Goldin, P. Greenland, A. D. Guerci, J. A.C. Lima, D. J. Rader, G. D. Rubin, et al.
Assessment of Coronary Artery Disease by Cardiac Computed Tomography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology
Circulation, October 17, 2006; 114(16): 1761 - 1791.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
C. M. Jones, T. Athanasiou, N. Dunne, J. Kirby, S. Attaran, A. Chow, S. Purkayastha, and A. Darzi
Multi-slice computed tomography in coronary artery disease.
Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 443 - 450.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EchocardiogrHome page
L. P. Salm, J. D. Schuijf, A. de Roos, H. J. Lamb, H. W. Vliegen, J. W. Jukema, R. Joemai, E. E. van der Wall, and J. J. Bax
Global and regional left ventricular function assessment with 16-detector row CT: Comparison with echocardiography and cardiovascular magnetic resonance
Eur J Echocardiogr, August 1, 2006; 7(4): 308 - 314.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Di Lazzaro, T. Ragni, G. Di Manici, G. Bardelli, U. Da Col, F. Grasselli, A. Antoniella, W. Papa, F. Crusco, and A. Giovagnoni
Noninvasive midterm follow-up of radial artery bypass grafts with 16-slice computed tomography.
Ann. Thorac. Surg., July 1, 2006; 82(1): 44 - 50.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
G. M. Feuchtner, W. Dichtl, T. Schachner, S. Muller, A. Mallouhi, G. J. Friedrich, and D. z. Nedden
Diagnostic performance of MDCT for detecting aortic valve regurgitation.
Am. J. Roentgenol., June 1, 2006; 186(6): 1676 - 1681.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
E. Escolar, G. Weigold, A. Fuisz, and N. J. Weissman
New imaging techniques for diagnosing coronary artery disease.
Can. Med. Assoc. J., February 14, 2006; 174(4): 487 - 495.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
P M Donnelly, J D S Higginson, and P D Hanley
Multidetector CT coronary angiography: have we found the holy grail of non-invasive coronary imaging?
Heart, November 1, 2005; 91(11): 1385 - 1388.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. V. Manchio, J. Gu, L. Romar, J. Brown, J. Gammie, R. N. Pierson III, B. Griffith, and R. S. Poston
Disruption of Graft Endothelium Correlates With Early Failure After Off-Pump Coronary Artery Bypass Surgery
Ann. Thorac. Surg., June 1, 2005; 79(6): 1991 - 1998.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
M. J. Garcia
Noninvasive Coronary Angiography: Hype or New Paradigm?
JAMA, May 25, 2005; 293(20): 2531 - 2533.
[Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
T. Schlosser, K. Pagonidis, C. U. Herborn, P. Hunold, K.-U. Waltering, T. C. Lauenstein, and J. Barkhausen
Assessment of Left Ventricular Parameters Using 16-MDCT and New Software for Endocardial and Epicardial Border Delineation
Am. J. Roentgenol., March 1, 2005; 184(3): 765 - 773.
[Abstract] [Full Text] [PDF]

Home page
 RadioGraphicsHome page
L. Wexler
Invited Commentary
RadioGraphics, March 1, 2005; 25(2): 438 - 440.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, B. H. Greenberg, J. D. Knoke, K. U. Knowlton, W. Y.W. Lew, J. Narula, D. Sahn, et al.
Highlights of the year in JACC 2004
J. Am. Coll. Cardiol., January 4, 2005; 45(1): 137 - 153.
[Full Text] [PDF]

Home page
 Journal Watch CardiologyHome page
CT Scanners Can Visualize Bypass Grafts
Journal Watch Cardiology, December 10, 2004; 2004(1210): 7 - 7.
[Full Text]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2004 by the American College of Cardiology Foundation.