Computed Tomography Coronary Angiography in Patients With a Previous Coronary Artery Bypass Graft Surgery Trial
Computed Tomography Coronary Angiography in Patients With a Previous Coronary Artery Bypass Graft Surgery Trial
This randomized, multi-center, prospective study seeks to compare the conventional invasive
 Coronary Angiography with the recently described method of performing CT-Coronary Angiography
 prior to the invasive Coronary Angiography, in post - CABG patients subjected to coronary
 angiography or percutaneous coronary intervention.
Conventional invasive coronary angiography is currently used to depict coronary arteries,
 however in recent years, the use of CT-coronary angiography has emerged in the literature for
 being a non-invasive and well tolerated examination, with imaging findings often equivalent
 to standard coronary angiography, especially for imaging grafts in patients undergone
 coronary artery bypass graft surgery (CABG).

 These patients present with complex anatomy of the coronary arteries making invasive coronary
 angiography a demanding and time-consuming examination in which the patient is exposed to
 large doses of radiation and volume of contrast.

 Multislice computed tomography shows high diagnostic accuracy in the detection of obstruction
 of the grafts while the advancement of technology continuously improves the diagnostic
 accuracy of the imaging findings. Of course, axial coronary angiography is more sensitive and
 specialized in the imaging of grafts, compared to the native coronary arteries of the heart.

 Therefore, the use of CT-coronary angiography before performing the respective invasive
 procedure is believed that it may reduce the overall duration of the procedure, the radiation
 received by the patient and the amount of contrast administered.

 The aim of the present study is to compare the performance of CT-coronary angiography before
 invasive coronary angiography compared with the performance of invasive coronary angiography
 alone. Τhe extent to which the information obtained from CT-coronary angiography contributes
 to the guidance of invasive coronary angiography that will follow will be studied, regarding
 the total procedure time, the volume of the contrast administered the radiation to which the
 patient is exposed and the patient's course over a period of 30 days.
Inclusion Criteria:

 -  Prior CABG-operation

 -  Age>18 years

 -  Indication for coronary angiography

 -  Informed consent

 Exclusion Criteria:

 -  STEMI

 -  NSTEMI very high risk or high risk (GRACE score >140, dynamic new ST/T ECG changes)

 -  Hemodynamic instability

 -  High probability of patient's non-compliance with the study's procedures.

 -  Severe kidney disease with GFR<30 mL/min/1.73m2

 -  Known allergic reaction to contrast

 -  Uncontrolled Arrhythmias (mostly afib) with heart rate over 80 bpm or frequent ectopic
 beats which could affect the ECG-gated cCTA protocol.

 -  BMI>40