Use of multi-slice computed tomography to determine the cause of symptom recurrence after coronary artery bypass grafting and factors impacting long-term graft patency

Abstract

Abstract Background Multi-detector computed tomography (MDCT) has proven to be beneficial for precise noninvasive examination of the coronary artery as well as bypass grafts. The aims of our study were to find out the cause of recurrence of symptoms after CABG surgery as well as the assessment of clinical and surgical factors that can affect the long-term patency of the coronary bypass grafts by the use of multi-slice coronary CT angiography. Methods We prospectively enrolled 48 symptomatic patients with recurrent anginal symptoms after CABG surgery. Results The patency rate of arterial grafts is 89.6% and of venous grafts is 59%. As regards the cause of symptoms, 56.3 and 18.8% of the patients had progression of atherosclerosis and graft occlusion, respectively, as causes. There was no statistically significant correlation between the patency of the arterial grafts and the degree of proximal native anastomotic artery stenosis, smoking, comorbidities, patient age, graft type, or age of the graft. For the venous grafts, there is no relation between the long-term patency of the venous graft and the length of the venous graft or the distance from the aorta-saphenous vein graft (SVG) anastomotic site to the coronary ostium, yet the results reveal significant effects of diabetes, dyslipidemia, and smoking on the long-term patency of the venous graft. Conclusion Atherosclerosis progression is the most common cause of postoperative symptom recurrence, followed by mixed graft occlusion and atherosclerosis advancement. High patency rate of arterial grafts with no significant effect of variable comorbidities on the long-term patency of arterial grafts. Dyslipidemia, diabetes, and smoking have significant effects on the long-term patency of the venous grafts.