Three-dimensional reconstruction of electron beam computed tomography angiography for evaluating coronary artery bypass grafts

Objectives To probe into electron beam computed tomography (EBCT) angiography and 3-D reconstruction of coronary artery bypass grafts (CABG) and to evaluate the clinical application of EBCT angiography and 3-D reconstruction of CABG. Methods EBCT angiography with 3-D reconstruction was achieved in 150 patients (142 men and 8 women, mean age, 57 +/- 8 years) with 399 grafts including 100 internal mammary artery grafts (IMG), 296 saphenous Vein grafts(SVG) and 3 radial artery grafts (RAG) respectively. The time from bypass surgery to EBCT scanning ranged from 7 days to 120 months, averaging 15 +/- 28 months. Enhanced single slice mode (SSM) and flow studies were performed in ail patients. The results of 3-D reconstruction of CABG were compared with bypass operation records and with coronary arteriograms (7 patients). Results 150 patients underwent successfully EBCT angiography and CABG 3-D reconstruction. According to 3-D reconstruction of the coronary bypass grafts with flow studies, 318 of 399 coronary bypass grafts were patent including IMG patency in 87/100 (87%), SVG in 228/296 (77%) and RAG in 3/3 (100/100). The overall patent rate was 79.7%. In 7 patients with 12 coronary bypass grafts, EBCT studies showed graft patency (7 grafts) and occlusion (5), which were confirmed by conventional graft angiography. Conclusions EBCT angiography with 3-D reconstruction is effective in providing the entire anatomic structure of coronary bypass grafts and evaluating coronary bypass graft patency. EBCT flow study can provide quantitative data for evaluating coronary bypass graft patency and for supplemental diagnosis of CABG 3-D reconstruction. EBCT angiography is a noninvasive technique that could replace conventional coronary arteriography for follow-up survey of coronary bypass surgery in future.