Contrast-enhanced cardiac MRI before coronary artery bypass surgery: Impact of myocardial scar extent on bypass flow

Peter Hunold*, Parwis Massoudy, Claudia Boehm, Thomas Schlosser, Kai Nassenstein, Stephan Knipp, Holger Eggebrecht, Matthias Thielmann, Raimund Erbel, Heinz Jakob, Jörg Barkhausen

*Corresponding author for this work

    Abstract

    The aim of the study was to relate the extent of myocardial late gadolinium enhancement (LGE) in cardiac MRI to intraoperative graft flow in patients undergoing coronary artery bypass graft (CABG) surgery. Thirty-three CAD patients underwent LGE MRI before surgery using an inversion-recovery GRE sequence (turboFLASH). Intraoperative graft flow in Doppler ultrasonography was compared with the scar extent in each coronary vessel territory. One hundred and fourteen grafts were established supplying 86 of the 99 vessel territories. A significant negative correlation was found between scar extent and graft flow (r=-0.4, p<0.0001). Flow in grafts to territories with no or small subendocardial scar was significantly higher than in grafts to territories with broad nontransmural or transmural scar (75±39 vs. 38±26 cc min-1; p<0.0001). In summary, the extent of myocardial scar as defined by contrast-enhanced MRI predicts coronary bypass graft flow. Beyond the probability of functional recovery, preoperative MRI might add value to surgery planning by predicting midterm bypass graft patency.

    Original languageEnglish
    JournalEuropean Radiology
    Volume18
    Issue number12
    Pages (from-to)2756-2764
    Number of pages9
    ISSN0938-7994
    DOIs
    Publication statusPublished - 26.06.2008

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