Electron Beam Computed Tomographic Angiography and 3-Dimensional Reconstruction of a Stented Saphenous Vein Graft
A 70-year-old man with exertional angina presented for cardiac catheterization. The past medical history was significant for coronary artery bypass graft surgery in 1984 with placement of a left internal mammary artery (LIMA) graft to the left anterior descending coronary artery and a single saphenous vein graft, sequentially, to 2 obtuse marginal vessels and the posterior descending coronary artery. At catheterization, the patient was found to have a patent LIMA graft; however, the saphenous vein graft was occluded mid vessel. The graft was subsequently repaired percutaneously with angioplasty and placement of a 5-mm-diameter, 50-mm-long stent. Three months later, the patient returned for electron beam computed tomographic angiography. Images were acquired as 3-mm slices taken with a single breath-hold and intravenous administration of 120 ml of iodinated contrast. Three-dimensional reconstruction of the heart and grafts (Figure⇓) demonstrated a widely patent saphenous vein graft (small arrows). The proximal and distal margins of the stent are also seen (large arrows). The patient remains asymptomatic.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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