双源CT冠状动脉血管造影对冠脉搭桥术后桥血管随访的应用价值

Diagnostic value of dual-source computed tomography coronary angiography for follow-up of bypass grafts after coronary artery bypass grafting

目的探讨双源CT冠状动脉血管造影(DSCTCA)对冠脉搭桥术后桥血管的诊断价值。方法回顾性分析38例冠状动脉旁路移植术(CABG)术后患者行DSCTCA,分别评价桥血管近远端吻合口及桥血管本身通畅情况,比较不同桥血管类型的通畅率及CABG术后随访5年前后的通畅率。结果 38例患者共95条桥血管,动脉桥及序贯桥的通畅率(22/25,88.0%,22/25,88.0%)高于静脉桥通畅率(28/45,62.2%),差异有统计学意义(x^2=5.233,P=0.022)。以5年为随访期限,5年以内桥血管的通畅率(62/77,80.5%)高于5年以外(≥5年)桥血管的通畅率(10/18,55.6%),差异有统计学意义(x^2=4.955,P=0.026)。结论 DSCTCA在冠状动脉搭桥术后随访中具有重要的临床应用价值。

【Objective】To discuss the diagnostic value of dual-source computed tomography coronary angiography（DSCTCA） for bypass grafts after coronary artery bypass grafting（CABG）.【Methods】Thirty-eight cases underwent DSCTCA after CABG were retrospectively analyzed. Graft proximal and distal anastomosis and graft patency itself were respectively evaluated, and graft patency rates of different types and different follow-up time（in fi ve years or afer fi ve years） were compared.【Results】Ninety-fi ve grafts in 38 patients were found, patency rate of arterial and sequential grafts（22/25, 88.0%; 22/25, 88.0%） were higher than vein graft patency rate（28/45, 62.2%）（x^2=5.233 P =0.022）. In 5-year follow-up period, graft patency rate（62/77, 80.5%） in fi ve years is higher than beyond fi ve years（10/18, 55.6%）（x^2= 4.955, P =0.026）.【Conclusion】DSCTCA is of important clinical value in follow-up of grafts after CABG.