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Congress: ECR25
Poster Number: C-14612
Type: Poster: EPOS Radiologist (scientific)
Authorblock: N. Jain, P. Chaturvedi, A. Singh, S. Jain, A. Gupta; Lucknow/IN
Disclosures:
Neeraj Jain: Nothing to disclose
Pragya Chaturvedi: Nothing to disclose
Anuradha Singh: Nothing to disclose
Shweta Jain: Nothing to disclose
Archna Gupta: Nothing to disclose
Keywords: Cardiac, CT-Angiography, Diagnostic procedure, Arteriosclerosis
Purpose Long-term graft patency is the primary goal of coronary artery bypass graft (CABG) surgery. Despite advancements in surgical techniques, a significant proportion of coronary artery bypass grafts experience failure over time. On average, the patency of venous grafts decreases to 81%, 75%, and 50% at 1, 5, and 10 years, respectively. This high failure rate has driven a transition to arterial conduits, such as internal mammary artery (IMA) grafts. Arterial grafts, in comparison, demonstrate significantly better long-term outcomes, with a...
Read more Methods and materials This retrospective observational study included 105 patients with a history of CABG who underwent CTCA between January 2015 and March 2020. Patients with uninterpretable images or implanted metallic cardiac devices, which might interfere with image quality, were excluded from the analysis.CTCA Protocol: All scans were performed on a 64-slice Philips Ingenuity CT scanner using retrospective ECG-gating. The scanning range extended from the thoracic inlet to the lung bases to include the origin of internal mammary arteries and bypass grafts. Non-ionic,...
Read more Results A total of 288 grafts from 105 patients were included in the study, with a female-to-male ratio of 9:1 and a mean age of 62 years. Aortic calcification was observed in 90.5% of patients, while aortic valvular calcification was seen in 10.5%. The mean diameters of arterial and venous grafts were 2.2 mm and 2.9 mm, respectively. Venous grafts accounted for 54% of conduits, while arterial grafts represented 36%. Overall, 3.5% of arterial grafts and 19.5% of venous grafts were...
Read more Conclusion Graft occlusion remains a common complication of CABG, with venous grafts showing higher failure rates compared to arterial grafts. CTCA is an effective modality for assessing graft patency and native artery status, offering a non-invasive alternative to traditional methods. Factors such as competitive flow from native arteries and graft type significantly influence patency, underscoring the need for individualized approaches to graft selection and placement. Further research is warranted to explore these factors and improve long-term outcomes for CABG patients.
Read more References Fitzgibbon GM, Kafka HP, Leach AJ, et al. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol 1996;28:616-626.   Barner HB, Standeven JW, Reese J. Twelve-year experience with internal mammary artery for coronary artery bypass. J Thorac Cardiovasc Surg 1985;90:668-75.   Cameron A, Davis KB, Green G, et al. Coronary bypass surgery with internal-thoracic-artery grafts--effects on survival over a 15-year period. N Engl J Med 1996;334:216-219.   Hillis...
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