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(Circulation. 2002;105:e9067.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

High-Resolution Magnetic Resonance Angiography Differentiates Patent and Occluded Vein Grafts

High-resolution, navigator-gated, 3-dimensional magnetic resonance (MR) angiography not only provided good differentiation between patent and occluded vein grafts but also allowed experts to make a fairly good assessment of vein graft disease, according to a group led by Ernst E. van der Wall, MD, from the Leiden University Medical Center Departments of Cardiology, Radiology, and Medical Statistics and the Interuniversity Cardiology Institute of the Netherlands in Utrecht, in a report in this week’s issue of Circulation (Circulation. 2002;105:328–333).

In explaining their study, the authors noted that although coronary angiography is the gold standard for evaluating the status of vein grafts after coronary artery bypass graft (CABG) surgery, the procedure is invasive, requires x-ray exposure and (in some venues) hospitalization, and involves a slight risk of complications. All of these represent disadvantages to using the procedure to screen patients who have postoperative angina. Their study was an attempt to evaluate a noninvasive diagnostic alternative.

The small patient population included 38 patients with 56 vein grafts who were scheduled for coronary angiography because of postoperative angina. High-resolution MR angiography scans were performed on these patients as part of an MR cardiac function protocol in which adenosine stress testing was performed. Excluded from the study were patients with stents in the graft or near the distal graft anastomosis, unstable angina, a pacemaker, atrial fibrillation, claustrophobia, or the inability to lie flat. The MR angiography was performed before coronary angiography in 19 patients and after coronary angiography in the other 19. According . . . [Full Text of this Article]