Cardiac Ct Evaluation Of Post Cabg Graft Assessment

Abstract

AIM: To study the cardiac CT evaluation of post CABG graft assessment.

MATERIALS AND METHODS: A Prospective cross-sectional study including 25 post CABG patients at Dr. D. Y. Patil Medical College, Pimpri, Pune in between September 2020 to July 2022. The patients were given a brief explanation of the procedure before the commencement of the CT scan. Patients with normal RFT and NBM status for a minimum of 4 hours were taken. A 128-section multidetector CT scanner is used to scan patients (Philips Medical Systems).

RESULTS: The total number of grafts assessed was 68 grafts. Out of which 25 grafts (36%) were arterial grafts and 43 grafts (64%) were venous grafts. Comparison of mean percentage stenosis of all venous grafts vs all arterial grafts were highly significant (p- value <0.001) and arterial grafts had better graft patency than venous grafts. Graft occlusion was compared between symptomatic and asymptomatic patients using the Chi-square test which was highly significant (p-value <0.001) and there was a positive correlation between symptoms and graft stenosis. The assessment of stenosis or occlusion of arterial bypass grafts on MDCT in comparison to ICA resulted in a sensitivity of 100%, specificity of 100% respectively. The diagnostic accuracy of MDCT is 100%. The assessment of stenosis or occlusion of venous bypass grafts on MDCT in comparison to ICA resulted in a sensitivity of 100%, specificity of 93.33% respectively. The diagnostic accuracy of MDCT is 96.83%. The graft stenosis percentages on CT were obtained. Grafts are graded as minimal, mild, moderate, and severe based on the percentage of stenosis. Total grafts with no stenosis (37 grafts), minimal stenosis (1 graft), mild stenosis (1 graft), moderate stenosis (5 grafts), and severe stenosis (24 grafts).

CONCLUSION: A direct correlation between symptoms and the degree of stenosis of grafts. As compared to arterial grafts, venous grafts had lower long-term patency. MDCT was found to be on par with ICA in the aspects of sensitivity, specificity, and diagnostic accuracy and due to the growing demand for faster scanning, reduced contrast agent use, and radiation exposure, as well as ongoing technological advancement, the MDCT will play an increasingly important role in the monitoring of CABG patients, CAD, and all other situations that call for a non-invasive, quick, and reliable diagnostic technique.