Evaluation of Left Ventricular Function by 64-Multidetector Computed Tomography in Patients Undergoing Totally Endoscopic Coronary Artery Bypass Grafting

摘要

The goal of this study was to quantify left ventricular (LV) function with automated 3-dimensional volume segmentation by 64-slice computed tomography (CT) in patients undergoing totally endoscopic coronary artery bypass grafting (CABG).We used 64-multidetector CT coronary angiography to examine 63 patients with >70% coronary stenosis who were undergoing totally endoscopic CABG for single-vessel disease (left internal mammary artery to left anterior descending coronary artery) or multivessel disease with the da Vinci robotic surgical device (arrested heart approach). CT measurements were compared with cineventriculography results in 20 patients.The intraobserver variability values for the end-systolic volume (ESV) and the end-diastolic volume (EDV) were excellent (7.2% and 5.2%, respectively). Bland-Altman plots showed good upper and lower limits of agreement (ESV, +9% and -3.3%, respectively; EDV, +17% and -5.9%). Intraobserver variability for the LV ejection fraction (LVEF) was 4.8% with narrow limits of agreement (+7.8%, -2.2%). The mean postprocessing time was 6.5 minutes. Mean values (+/-SD) were 62.7% +/- 12% (range, 23%-86%) for LVEF, 98.4 mL +/- 29 mL for EDV, and 38.3 mL +/- 23 mL for ESV. The LVEF obtained via CT was moderately but significantly correlated with the invasive cineventriculogram (r = 0.51; P = .02; limits of agreement, +18.7% and -18.4%).. Through the use of automated LV volume segmentation, 64-slice CT permits fast quantification of LV function in patients with coronary artery disease undergoing totally endoscopic CABG grafting, enabling a comprehensive evaluation of coronary arteries and bypass grafts.