Role of cardiac CT in the evaluation of coronary stents and coronary artery by-pass grafts

The speaker discusses the importance of optimizing scan protocols when using coronary stents. They highlight the effects of increasing the kilovoltage (kV) on image quality, noting that while this reduces blooming effects, it also decreases contrast enhancement within the stent.The speaker then moves on to discuss the role of cardiac CT in evaluating bypass grafts. They explain that cardiac CT can be useful in identifying patients with stenosis or occlusion of the coronary graft, and that it is particularly effective for imaging larger grafts such as arterial grafts.The speaker also discusses the diagnostic accuracy of cardiac CT in detecting graft occlusion, noting that sensitivity and specificity are both high (approaching 100%). They also mention that cardiac CT can be useful in evaluating native coronary arteries, although this can be more challenging due to smaller vessel diameter and calcifications.Finally, the speaker concludes by outlining the indications for cardiac CT in patients after coronary revascularization. They note that cardiac CT is indicated in asymptomatic patients with a left main stenosis or bypass grafts, and that future advancements such as cardiac perfusion imaging and CTFFR may help identify patients who will benefit from further treatment.Please let me know if you need any further assistance!