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J Thorac Cardiovasc Surg 2005;129:686-687
© 2005 The American Association for Thoracic Surgery

Brief Communications

Could multidetector computed tomography play a role in the management of patients readmitted with recurrent chest pain after surgical coronary revascularization?

^a Department of Clinical Science and Bioimaging, Section of Radiology, University "G. d'Annunzio," Chieti, Italy
^b Department of Bioimaging and Radiological Science, Institute of Radiology, Catholic University, Rome, Italy

Received for publication September 23, 2004; accepted for publication October 12, 2004.

^* Address for reprints: Riccardo Marano, MD, Department of Clinical Science and Bioimaging, Section of Radiology, University "G. d'Annunzio" Chieti, Italy, Via dei Vestini 66100, Chieti, Italy (E-mail: r.marano@rad.unich.it).

The first 20% of the full text of this article appears below.

Coronary artery bypass graft (CABG) surgery is still one of the most performed surgical procedures worldwide, and arteriosclerotic graft disease is an important issue in cardiology, as shown by the increasing number of patients readmitted with recurrent chest pain after surgical revascularization or abnormal diagnostic test results. The availability of a noninvasive diagnostic tool to assess-exclude the presence of CABG disease could be of great clinical benefit for the management of patients. The imaging of coronary arteries by computed tomography has become reliable with the development of multidetector technology and the introduction of multidetector computed tomography (MDCT) at the end of the 1990s.

	Clinical summary

 
A 49-year-old man who had undergone CABG surgery 3 years previously was readmitted to the hospital for atypical angina and stress dyspnea. Table 1 illustrates the patient's baseline clinical parameters and graft typology. Echocardiography showed normal left ventricular wall kinesis; at rest, electrocardiographic (ECG) results were normal, whereas a stress test showed a slight T-wave inversion in V4-6 without chest pain. For these reasons, the patient underwent retrospectively ECG-gated MDCT with the purpose of assessing the graft patency.