Coronary artery bypass follow-up

Body Region: Cardiovascular
Author: Valentina Silvestri, François Pontana

1. Patient presentation
2. CT Images
3. CT Findings
4. Diagnosis
5. References


1. Patient presentation

  • A 70-year-old man was referred by his cardiologist for recurrence of chest pain.
  • His medical history included severe ischemic cardiomyopathy treated on multiple occasions over 5 years by percutaneous coronary intervention with stenting of the three trunks. Then, because of the recurrence of stenosis, he had undergone surgical revascularization by coronary artery bypass grafting (CABG): left internal mammary artery (LIMA) on the left anterior descending (LAD) artery, right internal mammary artery (RIMA) on the first obtuse marginal (OM) artery, and great saphenous vein (GSV) on the right coronary artery (RCA). Five years later, abrupt clinical deterioration required to another coronary angiography procedure, which showed GSV graft occlusion; this was treated with double stenting. One year later, the patient was referred once again to our institute due to recurrence of symptoms.
  • Coronary CT angiography was performed in emergency to rapidly assess CABG patency.

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