MDCT of the proximal anastomoses created by nitinol implants in coronary artery bypass grafting: a retrospective two-observer evaluation

The purpose of this study was to investigate the proximal anastomosis of CABG grafts created by a nitinol aortic connector. After receiving CABG, 33 patients underwent CT examination of the heart. On the same patients, CT was performed on postoperative day 5 (4-row CT, group A) and again 1 year thereafter (16-row CT, group B). Twenty-three ACVB to RCX and 27 ACVB to RCA grafts were included. Every anastomosis was reviewed under different reformations (MIP, MPR and VRT). Interobserver correlation was determined. Five days postoperatively, 48/50 anastomoses were classified as patent. One year postoperatively, 42/50 anastomoses were classified as patent. In both groups, the aortic connector could be visualized with good quality: 1.82±1.10 (group A) and 1.93±1.22 (group B) for ACVB to RCA, similar results for ACVB to RCX grafts (MPR). Image quality at the aortic connector site did not display a significant difference for any reformation between groups (P>0.05). Within groups, MPR displayed better visualization than MIP and VRT (P<0.05). In the presence of metal implants, CT provides reliable data in evaluation of the proximal anastomosis. Sixteen-row CT does not bring a significant benefit to image quality. MPR displayed the best visualization within both groups.