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Cardiac CT Angiography After Coronary Bypass Surgery: Prevalence of Incidental Findings

¹ Department of Diagnostic Radiology, University of Maryland School of Medicine, 22 S Greene St., Baltimore, MD 21201.
² Present address: Department of Radiology, Allegheny General Hospital, Pittsburgh, PA.
³ Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.

View larger version (182K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Scout topogram shows typical field of view used for each examination. To include entire course of internal mammary arteries, craniocaudad (z-axis) field of view is more cephalad than typical cardiac CT angiography.

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —45-year-old man who underwent cardiac CT angiography 6 days after coronary bypass grafting surgery. Axial CT image shows anterior ventricular pseudoaneurysm (white arrow) and large hemopericardium (open arrow). Patient had good recovery after surgery.

View larger version (185K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —73-year-old man who underwent routine cardiac CT angiography 7 days after coronary bypass grafting surgery. Axial CT image shows thrombus in left atrial appendage (arrow). Intraoperative transesophageal echocardiogram showed no intracardiac thrombus (not shown).

View larger version (157K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —67-year-old man who underwent coronary artery bypass grafting surgery after inferior myocardial infarction. Axial CT image from routine cardiac CT angiography 7 days after surgery shows unsuspected left ventricular thrombus (arrowhead).

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —63-year-old symptomatic man who underwent routine cardiac CT angiography 2 days after coronary artery bypass grafting surgery. Axial CT image shows saddle pulmonary embolism (arrow).

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —A 1.1-cm spiculated left upper lobe pulmonary nodule, (arrows) was discovered in 76-year-old man shortly after coronary bypass. Percutaneous lung biopsy revealed carcinoma.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7 —56-year-old woman with unsuspected thrombosed aortocoronary saphenous vein graft (arrow) 5 days after coronary artery bypass grafting procedure.

View larger version (166K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —63-year-old asymptomatic man who underwent cardiac CT angiography 3 days after coronary bypass grafting surgery. Axial CT image shows left ventricular aneurysm (arrow).

View larger version (160K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —63-year-old asymptomatic man who underwent cardiac CT angiography 3 days after coronary bypass grafting surgery. Oblique multiplanar reformatted image in vertical long axis projection confirms inferior ventricular pseudoaneurysm (arrow). LA = left atrium, LV = left ventricle.

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