What are imaging pearls for coronary computed tomography angiography (CCTA) of coronary bypass grafts?

Updated: Dec 21, 2017
  • Author: Eugene C Lin, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Note the following:

  • Artifact from surgical clips can limit graft evaluation by CCTA. The distal anastomosis in particular can be difficult to assess due to motion and/or clip artifacts.

  • The most challenging aspect of CCTA in post-CABG patients is often evaluation of the native vessels. In one study, 29% of native vessel segments could not be evaluated in CABG patients. [37]

  • Proximity of the graft(s) to the sternum should be described to avoid damage during a redo sternotomy. If the graft abuts the sternum, the position of the graft relative to the sternal notch should be reported. [38]

  • In patients with internal mammary grafts, the scan should extend superiorly to the level of the clavicle so that subclavian stenosis can be ruled out.


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