Diagnostic accuracy of 64-slice multidetector computed tomography for selecting coronary artery bypass graft surgery candidates

Hye Jeong Lee, Jung Sun Kim, Young Jin Kim, Jin Hur, Kyung Jong Yoo, Kyu Ok Choe, Byoung Wook Choi

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Objective: The objective of our study was to investigate the diagnostic accuracy of computed tomographic coronary angiography for the selection of candidates for coronary artery bypass graft surgery. Methods: Institutional review board approval was obtained. We included 172 patients (mean age, 63 years; 127 men and 45 women) with a suspicion of coronary artery disease who underwent both computed tomographic coronary angiography and conventional coronary angiography. We established eligible criteria for coronary artery bypass graft surgery based on American College of Cardiology/American Heart Association practice guidelines: 3-vessel disease, left main coronary artery disease, and left main coronary artery equivalent disease. Results of computed tomographic coronary angiography and conventional coronary angiography were reviewed retrospectively by 2 radiologists and 2 cardiologists who were unaware of the other examiners' findings. Diagnostic performances of computed tomographic coronary angiography were calculated, with conventional coronary angiography as the reference standard. Results: The overall sensitivity, specificity, positive predictive value, and negative predictive value of computed tomographic coronary angiography for the selection of coronary artery bypass graft surgery candidates were 85.9%, 96.0%, 93.8%, and 90.7%, respectively. We also obtained high diagnostic performances for 3-vessel disease (sensitivity, 83.1%; specificity, 96.5%; positive predictive value, 92.5%; negative predictive value, 91.6%), left main coronary artery disease (sensitivity, 94.7%; specificity, 96.7%; positive predictive value, 78.3%; negative predictive value, 99.3%), and left main coronary artery equivalent disease (sensitivity, 100%; specificity, 100%; positive predictive value, 100%; negative predictive value, 100%). Conclusions: Patients selected as candidates for coronary artery bypass graft surgery with conventional coronary angiography can also be relatively accurately classified by using computed tomographic coronary angiography with 64-slice multidetector computed tomography.

Original languageEnglish
Pages (from-to)571-577
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume141
Issue number2
DOIs
Publication statusPublished - 2011 Feb

Bibliographical note

Funding Information:
We established eligible criteria for CABG based on practice guidelines developed by the American College of Cardiology Foundation and the American Heart Association. 9 The criteria for CABG were as follows: (1) left main (LM) disease, which was defined as a 50% or greater diameter stenosis in the LM coronary artery; (2) 3-vessel coronary disease, which was defined as a 50% or greater diameter stenosis in all 3 main coronary arteries; or (3) LM equivalent disease, which was defined as a 70% or greater diameter stenosis at the proximal left anterior descending coronary artery (LAD) with a 70% or greater diameter stenosis at the proximal left circumflex coronary artery (LCx). We did not consider any clinical subset, such as diabetes mellitus or congestive heart failure, as criteria for a CABG.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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