• Tahir Naveed
  • Muhammad Ayub
  • Mohsin Nazeer
  • Nadeem Hayat Mallick
  • Bilal S. Mohydin
  • Zulfiqar Ali


Background: Coronary artery bypass graft surgery is a commonly performed revascularizationprocedure in ischemic heart disease patients. Conventional coronary angiography is an invasivemethod for evaluation of grafts in such patients. Non-invasive evaluation of grafts in post CABGpatient has been made possible with the advent of 64-Slice Multi Detector Computed Tomography(MDCT) .The Objective of the study was to non-invasively assess the graft patency with MDCT.Methods: Sixty post CABG patients (52 male, 8 female) with atypical chest pain or stable anginawere evaluated with MDCT for graft patency. The grafts were considered as patent if there wascontinuous lumen visualisation at origin, in the body and at its insertion with native recipientvessels. Grafts were defined as blocked when only stumps were seen. They were classified asstenotic if there was ≥50% diameter narrowing. Results: The mean age of the patients was60.1±9.7 years, mean duration since CABG was 8.01±6 years. Total number of grafts assessedwas 175 including 124 (71%) venous grafts and 51 (28.9%) arterial grafts. A total of 82/124(66.1%) venous grafts and 47/51 (92%) arterial grafts were patent. Forty-two (34%) venous graftswere blocked whereas 4 arterial grafts were not developed. Arterial grafts patency was 92% andvenous grafts patency was 67.7% after a mean follow up of 8.01±6 years. Conclusion: The studyshows that 64 slice MDCT can be used for the evaluation of patency and occlusion of venous andarterial grafts in post CABG patients for follow up.Keywords: Multi Detector Computed Tomography (MDCT), Coronary Artery Bypass Graft(CABG), Graft Patency (GP)


Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund

K, Haase N, et al. Heart Disease and stroke statistics—2007

update: a report From the American Heart Association

Statistics Committee and Stroke Statistics Subcommittee.

Circulation 2007;115:e69–e171.

Cameron AA, Davis KB, Rogers WJ. Recurrence of angina

after coronary artery bypass surgery: predictors and prognosis

(CASS Registry) Coronary Artery Surgery Study. J Am Coll

Cardiol 1995;26:895–9.

Fitzgibbon GM, Kafka HP, Leach AJ, Keon WJ, Hooper GD,

Burton JR. Coronary bypass graft fate and patient outcome:

angiographic follow-up of 5,065 grafts related to survival and

reoperation in 1,388 patients during 25 years. J Am Coll

Cardiol 1996;28:616–26.

Barner HB, Barnett MG. Fifteen- to twenty-one-year

angiographic assessment of internal thoracic artery as a

bypass conduit. Ann Thorac Surg 1994;57:1526–8.

Palmas W, Bingham S, Diamond GA, Denton TA, Kiat H,

Friedman JD, et al. Incremental prognostic value of exercise

thallium-201 myocardial single-photon emission computed

tomography late after coronary artery bypass surgery. J Am

Coll Cardiol 1995;25:403–9.

Gobel FL, Stewart WJ, Campeau L, Hickey A, Herd JA,

Forman S, White CW, Rosenberg Y. Safety of coronary

arteriography in clinically stable patients following coronary

bypass surgery. Post CABG Clinical trial Investigators.

Cathet Cardiovasc Diagn 1998;45:376–81.

Langerak SE, Vliegen HW, Roos AD, Zwinderman AH,

Jukema JW, Kunz P, et al. Detection of Vein Graft Disease

Using High-Resolution Magnetic Resonance Angiography.

Circulation 2002;105:328–33.

Schlosser T, Konorza T, Hunold P, Kühl H, Schmermund A,

Barkhausen J. Noninvasive visualization of coronary artery

bypass grafts using 16-detector row computed tomography. J

Am Coll Cardiol 2004;44:1224–9.

Martuscelli E, Romagnoli A, D’Eliseo A, Tomassini M,

Razzini C, Sperandio M, et al. Evaluation of Venous and

Arterial Conduit Patency by 16-Slice Spiral Computed

Tomography. Circulation 2004;110:3234–8.

Chiurlia E, Menozzi M, Ratti C, Romagnoli R, Modena

MG. Follow-up of coronary artery bypass graft patency by

multislice computed tomography. Am J Cardiol


Raff GL, Gallagher MJ, O Neill WW, Goldstein JA.

Diagnostic accuracy of noninvasive coronary angiography

using 64-slice spiral computed tomography. J Am Coll

Cardiol 2005;46:552–7.

Pache G, Saueressig U, Frydrychowicz A, Foell D,

Ghanem N, Kotter E, et al. Initial experience with 64-slice

cardiac CT: non-invasive visualization of coronary artery

bypass grafts. Eur Heart J 2006;27:976–80.

Tepel M, Aspelin P, LameireN. Contrast-Induced

Nephropathy: A Clinical and Evidence-Based Approach.

Circulation 2006;113:1799–806.

Nieman K, Pattynama PMT, Rensing BJ, Van Geuns RJM,

De Feyter PJ.Evaluation of Patients after Coronary Artery

Bypass Surgery: CT Angiographic Assessment of Grafts and

Coronary Arteries.Radiology 2003;229:749–56.

Dewey M, Lembcke A, Enzweiler C, Hamm B, Rogalla P.

Isotropic half-millimeter angiography of coronary artery

bypass grafts with 16-slice computed tomography. Ann

Thorac Surg 2004;77:800–4.

Song M.H, Ito T, Watanabe T, Nakamura H. Multidetector

computed tomography versus coronary angiogram in

evaluation of coronary artery bypass grafts. Ann Thorac Surg


Bautista AT, Estornell J, Ridocci F, Soriano CJ, Gudín M,

Vilar JV, et al. Non-Invasive Assessment of Coronary Artery

Bypass Grafts by Computed Tomography: Comparison With

Conventional Coronary Angiography. Rev Esp Cardiol


Hamon M, Lepage O, Malagutti P, Riddell JW, Morello R,

Agostini D, et al. Diagnostic Performance of 16- and 64-

Section Spiral CT for Coronary Artery Bypass Graft

Assessment: Meta-Analysis. Radiology 2008;247:679–86.

Roberts WT, Bax JJ, Davies LC. Cardiac CT and CT

coronary angiography: technology and application.

Heart 2008;94:781–92.

Yamamoto M, Kimura F, Niinami H, Suda Y, Ueno E,

Takeuchi Y. Noninvasive assessment of off-pump coronary

artery bypass surgery by 16-channel multidetector-row

computed tomography. Ann Thorac Surg 2006;81:820–7.

Batyraliev T, Ayalp M.R, Sercelik A, Karben Z, Dinler

G, Besnili F, et al. Complications of Cardiac Catheterization: A

Single-Center Study. Angiology 2005;56:75–80.

Wyman RM, Safian RD, Portway V, Skillman JJ, McKay

RG, Baim DS. Current complications of diagnostic and

therapeutic cardiac catheterization. J Am Coll Cardiol


Motwani JG. ,Topol E J. Aortocoronary Saphenous Vein

Graft Disease : Pathogenesis, Predisposition, and

Prevention. Circulation 1998;97:916–31.

VanDomburg RT, Foley DP, Breeman A, Van Herwerden

LA, Serruys PW. Coronary artery bypass graft surgery and

percutaneous transluminal coronary angioplasty. Twenty-year

clinical outcome. Eur Heart J 2002;23:543–9.

Ropers D, Ulzheimer S, Wenkel E, Baum U, Giesler T,

Derlien H, et al. Investigation of aortocoronary artery bypass

grafts by multislice spiral computed tomography with

electrocardiographic-gated image reconstruction. Am J

Cardiol 2001;88:792–5.

Stauder NI, Fenchel M, Stauder H, Küttner A, Scheule AM,

Kramer U, et al. Assessment of minimally invasive direct

coronary artery bypass grafting of the left internal thoracic

artery by means of magnetic resonance imaging. J Thorac

Cardiovasc Surg 2005;129:607–14.

Langerak SE, Vliegen HW, Jukema JW, Kunz P,

Zwinderman AH, Lamb HJ, et al. Value of magnetic

resonance imaging for the noninvasive detection of stenosis

in coronary artery bypass grafts and recipient coronary

arteries. Circulation 2003;107:1502–8.

Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M,

Martinoff S, et al. Radiation Dose Estimates From Cardiac

Multislice Computed Tomography in Daily Practice: Impact

of Different Scanning Protocols on Effective Dose

Estimates. Circulation 2006;113:1305–10.




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