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Early Postoperative Assessment of Coronary Artery Bypass Graft Patency and Anatomy: Value of Contrast-Enhanced 16-MDCT with Retrospectively ECG-Gated Reconstructions

Hélène Vernhet-Kovacsik1, Pascal Battistella2, Roland Demaria2, Jean Luc Pasquie3, Claudine Bousquet1, Georges Dogas1, Florence Leclercq3, Bernard Albat2 and Jean Paul Senac1

1 Department of Imaging, CHU Montpellier, 391 Avenue du Doyen Giraud, Montpellier 34295, France.
2 Department of Cardiovascular Surgery, CHU Montpellier, Montpellier 34295, France.
3 Department of Cardiology, CHU Montpellier, Montpellier 34295, France.


Figure 1
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  		Fig. 1A —72-year-old man. MDCT multiplanar volume-rendering image shows internal mammary artery-left descending artery graft with clipped side branches that project over graft.

 

Figure 2
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  		Fig. 1B —72-year-old man. Using linear reconstructions of graft lumen and views from two different angles offers different projections of metallic clips located close to graft so that entire lumen is shown.

 

Figure 3
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  		Fig. 1C —72-year-old man. Using linear reconstructions of graft lumen and views from two different angles offers different projections of metallic clips located close to graft so that entire lumen is shown.

 

Figure 4
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  		Fig. 2A —73-year-old man who underwent off-pump left internal mammary artery-left descending artery bypass graft surgery 12 days earlier. Surface shaded 3D CT image shows that recipient artery is diagonal artery.

 

Figure 5
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  		Fig. 2B —73-year-old man who underwent off-pump left internal mammary artery-left descending artery bypass graft surgery 12 days earlier. Diagonal artery was also assessed on conventional coronary angiography.

 

Figure 6
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  		Fig. 3 —MDCT multiplanar volume-rendering image of 69-year-old woman shows thrombosis of radial artery-diagonal artery graft. Graft could not be catheterized and enhanced at angiography.

 

Figure 7
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  		Fig. 4A —75-year-old man who had off-pump left internal mammary artery-left descending artery bypass graft surgery 1 week earlier. Both multiplanar volume-rendering CT image (A) and conventional angiography image (B) show stenosis that is greater than 50% located at distal anastomosis.

 

Figure 8
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  		Fig. 4B —75-year-old man who had off-pump left internal mammary artery-left descending artery bypass graft surgery 1 week earlier. Both multiplanar volume-rendering CT image (A) and conventional angiography image (B) show stenosis that is greater than 50% located at distal anastomosis.

 

Figure 9
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  		Fig. 5A —70-year-old man who had off-left internal mammary artery-left descending artery (LDA) bypass graft surgery 10 days earlier. Coronary angiography (A) shows dissection flap on recipient LDA that was well documented on cranial view (B) but that was missed at MDCT on multiplanar volume-rendering image (C).

 

Figure 10
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  		Fig. 5B —70-year-old man who had off-left internal mammary artery-left descending artery (LDA) bypass graft surgery 10 days earlier. Coronary angiography (A) shows dissection flap on recipient LDA that was well documented on cranial view (B) but that was missed at MDCT on multiplanar volume-rendering image (C).

 

Figure 11
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  		Fig. 5C —70-year-old man who had off-left internal mammary artery-left descending artery (LDA) bypass graft surgery 10 days earlier. Coronary angiography (A) shows dissection flap on recipient LDA that was well documented on cranial view (B) but that was missed at MDCT on multiplanar volume-rendering image (C).

 

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