TY - JOUR
T1 - Multi-Detector Computed Tomography in Coronary Artery Bypass Graft Assessment
T2 - A Meta-Analysis
AU - Jones, Catherine M.
AU - Athanasiou, Thanos
AU - Dunne, Nicola
AU - Kirby, Joanne
AU - Aziz, Omer
AU - Haq, Ahmed
AU - Rao, Christopher
AU - Constantinides, Vasilis
AU - Purkayastha, Sanjay
AU - Darzi, Ara
PY - 2007/1
Y1 - 2007/1
N2 - Multi-detector computed tomography (MDCT) has become an alternative to coronary angiography in diagnosis of graft occlusion and stenosis after coronary artery bypass. A literature search was performed for studies comparing angiography to 8-slice, 16-slice, and 64-slice MDCT in the assessment of coronary grafts. In assessing occlusion, 14 studies produced pooled sensitivity of 97.6%, specificity of 98.5%, diagnostic odds ratio of 934.2, area under the curve of 0.996, and Q* of 0.977. Ninety-six percent of all grafts were visualized for occlusion assessment. Beta blockers, symptomatic status, and postoperative period did not significantly affect diagnostic performance. Stenosis assessment produced sensitivity of 88.7% and specificity of 97.4%. Eighty-eight percent of patent grafts could be assessed for stenosis. The diagnostic accuracy of MDCT approaches angiography for diagnosing graft occlusion and stenosis in patients with venous and arterial coronary bypass grafts. Our findings show that cardiac surgeons will need to interpret MDCT images of both native and grafted vessels soon in preparation for primary or re-do coronary bypass grafting procedures.
AB - Multi-detector computed tomography (MDCT) has become an alternative to coronary angiography in diagnosis of graft occlusion and stenosis after coronary artery bypass. A literature search was performed for studies comparing angiography to 8-slice, 16-slice, and 64-slice MDCT in the assessment of coronary grafts. In assessing occlusion, 14 studies produced pooled sensitivity of 97.6%, specificity of 98.5%, diagnostic odds ratio of 934.2, area under the curve of 0.996, and Q* of 0.977. Ninety-six percent of all grafts were visualized for occlusion assessment. Beta blockers, symptomatic status, and postoperative period did not significantly affect diagnostic performance. Stenosis assessment produced sensitivity of 88.7% and specificity of 97.4%. Eighty-eight percent of patent grafts could be assessed for stenosis. The diagnostic accuracy of MDCT approaches angiography for diagnosing graft occlusion and stenosis in patients with venous and arterial coronary bypass grafts. Our findings show that cardiac surgeons will need to interpret MDCT images of both native and grafted vessels soon in preparation for primary or re-do coronary bypass grafting procedures.
UR - http://www.scopus.com/inward/record.url?scp=33845512535&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2006.08.018
DO - 10.1016/j.athoracsur.2006.08.018
M3 - Review article
C2 - 17184705
AN - SCOPUS:33845512535
SN - 0003-4975
VL - 83
SP - 341
EP - 348
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -