Dipartimento di Radiologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Radiol Med. 2009 Dec;114(8):1187-95. doi: 10.1007/s11547-009-0463-x. Epub 2009 Sep 30.
This study evaluated the morphological and functional results of surgical reconstruction of the left anterior descending (LAD) coronary artery with an autologous vein patch, associated with left internal mammary artery (LIMA) grafting onto the patch.
Cardiac computed tomography (CT) images were assessed in terms of functional and morphological parameters. Function was evaluated by assessing patency at 36 months of the reconstructed LAD (based on the attenuation of the native vessel distal to the anastomosis). Morphology was evaluated by studying vein-patch diameters, profiles and margins, shape and structure to categorise the patches into three groups (A, B, C). Within 1 month of CT, all patients underwent functional testing (bicycle ergometry).
CT imaging correctly depicted the LAD graft, revealing it to be fully patent in all cases. On the basis of our morphological classification, 21 patients were classed as group A, two as group B and two as group C. At bicycle ergometry, 23 patients were negative and two were positive. Group C patients had the worst functional results.
Cardiac CT allowed adequate evaluation of the LAD graft patency and morphology, and in consideration of its noninvasive nature, it may become the imaging tool of choice for evaluating extended LAD reconstruction.
本研究评估了使用自体静脉补片对左前降支（LAD）进行手术重建，并将左内乳动脉（LIMA）与补片吻合，以改善 LAD 重建的形态和功能结果。
对心脏 CT 图像进行形态和功能参数评估。功能通过评估重建 LAD 术后 36 个月吻合口远端的自体血管通畅情况进行评估（基于吻合口远端的自然血管的衰减）。形态通过研究静脉补片的直径、形态、边缘、形状和结构，将补片分为三组（A、B、C）进行评估。在 CT 后 1 个月内，所有患者均进行了功能测试（踏车运动试验）。
CT 成像正确显示了 LAD 移植物，所有病例均完全通畅。根据我们的形态学分类，21 例患者为 A 组，2 例为 B 组，2 例为 C 组。踏车运动试验中，23 例为阴性，2 例为阳性。C 组患者的功能结果最差。
心脏 CT 可充分评估 LAD 移植物的通畅性和形态，并且考虑到其非侵入性，它可能成为评估广泛 LAD 重建的首选影像学工具。
