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Eur J Cardiothorac Surg 2006;30:443-450
© 2006 Elsevier Science NL

Review

Multi-slice computed tomography in coronary artery disease

^a Department of Radiology, City Hospital, Dudley Road, Birmingham, UK
^b Department of Biosurgery and Surgical Technology, Imperial College London, 10th Floor QEQM building, St. Mary's Hospital, London W2 1NY, UK
^c Department of Cardiothoracic Surgery, Imperial College London, 10th Floor QEQM building, St. Mary's Hospital, London W2 1NY, UK
^d Royal Berkshire and Battle NHS Trust, London Road, Reading RG1 5AN, UK
^e Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, UK

Received 15 March 2006; received in revised form 20 May 2006; accepted 1 June 2006.

^_* Corresponding author. Tel.: +44 207 886 1147; fax: +44 207 886 6777. (Email: tathan5253{at}aol.com).

Multi-slice computed tomography technology is emerging as a realistic investigation in patients with suspected disease in native, stented or grafted coronary arteries. A non-invasive diagnostic tool is desirable as these patients are at high risk for complications of invasive angiography. A 64-slice CT may achieve the desired diagnostic accuracy, and overcome the limitations of spatial resolution, respiratory motion, artifacts from calcification and stents, and radiation dose considerations to produce reliable image quality. These advances, as well as the capacity for integrated functional cardiac assessment, may change the referral patterns in patients who have had previous bypass surgery or percutaneous intervention. This review outlines the debated issues about 64-slice cardiac CT in patients before and after coronary artery bypass surgery, as well as coronary stenting and functional assessment. A review of the recent literature on native coronary artery and bypass graft assessment by multi-slice CT is also performed.

Abbreviations: CA = coronary angiography • CABG = coronary artery bypass graft • CT = computed tomography • CTA = computed tomography angiography • EBT = electron beam tomography • ECG = electrocardiogram • LVWF = left ventricular wall function • MSCT = multi-slice CT • MRI = magnetic resonance imaging

Key Words: CABG new technology • Computed tomography • Multi-slice

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