@Article{Kępka2010,
journal="Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej",
issn="1734-9338",
volume="6",
number="1",
year="2010",
title="Original paperDual-source computed tomography angiography in patients after bypass grafting \– comparison with invasive coronary angiography",
abstract=" Background:  Assessment of bypass grafts by invasive coronary angiography (ICA) is bothersome and often requires extra procedure time, contrast load, and radiation exposure.    Aim:   To evaluate the ability of dual-source computed tomography angiography (CTA) to detect significant graft disease in symptomatic patients after coronary artery bypass grafting (CABG).   Methods:  Thirty (26 men, mean age 66 \± 9 years) consecutive post-CABG patients from the prospective ANIN Computed Tomography Angiography Registry who underwent both dual-source CTA and ICA for suspected graft disease were included in the analysis. Coronary artery bypass grafts, anastomotic sites, and distal runoffs with a diameter of \≥ 1.5 mm were evaluated for the presence of significant stenoses (\≥ 50% diameter reduction). Invasive coronary angiography served as a reference standard, and was performed within  \≤ 30 days of dual-source CTA.   Results:  A total of 58 bypass grafts with 56 anastomotic sites, and 54 distal runoffs were evaluable both in dual-source CTA and ICA. Sensitivity, specificity, and positive and negative predictive values of dual-source CTA for the detection of significant lesions in bypass grafts were 100%, 92%, 86%, and 100%, respectively. In anastomotic sites, dual-source CTA detected significant stenosis with  a sensitivity and specificity of 100% and 96%, respectively. If analysis was restricted to distal runoff segments, sensitivity and specificity were 50% and 98%, respectively. On a per-patient basis, all patients with at least one significant graft stenosis on ICA were correctly classified using dual-source CTA.   Conclusions:  Dual-source CTA permits the reliable assessment of bypass graft disease with high diagnostic accuracy and can be used in clinical routine as a noninvasive test to rule out suspected graft dysfunction in symptomatic post-CABG patients.",
author="Kępka, Cezary
and Opolski, Maksymilian P.
and Kruk, Mariusz
and Pręgowski, Jerzy
and Michałowska, Ilona
and Demkow, Marcin
and Witkowski, Adam
and Rużyłło, Witold",
pages="12--20",
doi="10.5114/pwki.2010.13821",
url="http://dx.doi.org/10.5114/pwki.2010.13821"
}