SPIRAL CT AND CT-ANGIOGRAPHY AFTER CORONA RY-BYPASS SURGERY

Aim: Evaluation of spiral-CT and CT-angiography for imaging of venous and arterial coronary bypass grafts during the early postoperative per iod. Patients and methods: In 198 patients suffering from coronary hea rt disease, 583 aortocoronary venous grafts (ACVG), 70 arterial grafts and 24 jumped grafts were investigated 9-15 days following coronary s urgery. In 57 patients the results were compared to arterial DSA and r econstructive CT-angiography. Results: At arterial DSA 93% of ACVG and 100% of arterial grafts were patent. Spiral-CT demonstrated 104 of 10 5 ACVG (99%) and 20 of 29 arterial grafts (69%) correct patent. All oc cluded ACVG (n = 8) were detected. 90% of ACVG but only 32% of arteria l grafts were visualised completely over long segments. Imaging of jum ped grafts was insufficient. In CT-angiography artificial vessel steno ses impaired correct visualisation of graft morphology. Conclusions: S piral-CT allows sufficient differentiation of patent and obstructed AC VG during the early postoperative period. Diagnostic of arterial graft s is of lower accuracy. For CT angiography of venous and arterial coro nary grafts further improvements are necessary.