Document Detail


Intraoperative angiography leads to graft revision in coronary artery bypass surgery.
MedLine Citation:
PMID:  15276506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Graft anastomosis quality in coronary artery bypass surgery can be assessed by intraoperative angiography. The aim of the present study was to quantify the on-table revision rate initiated by intraoperative angiography. METHODS: Intraoperative angiography was carried out in 186 patients undergoing coronary artery bypass surgery, with a total of 427 grafts. The operation was performed on-pump in 34%, off-pump through a sternotomy in 49%, and as a minimally invasive direct coronary bypass grafting (MIDCAB) procedure in 17%. The angiography was performed intraoperatively while the patients were still in general anesthesia, with the possibility for on-table revision. Follow-up angiography was carried out after a mean of 346 days. RESULTS: Eighteen of 427 grafts (4.2%) were revised due to the findings at intraoperative angiography. Revision rate after on-pump surgery was 1.1%, after off-pump through a sternotomy 6.4%, and after MIDCAB 6.5%. In 6 patients the lesions were located at the distal anastomoses and in 12 patients in the conduit. All but one was successfully revised, and at 1-year follow-up all these 17 grafts were patent. CONCLUSIONS: Intraoperative angiography saves a potential number of grafts that otherwise could have been occluded. An increased implementation of intraoperative quality assessment in coronary artery bypass surgery can lead to improved outcome.
Authors:
Per Kristian Hol; Per Snorre Lingaas; Runar Lundblad; Kjell Arne Rein; Karleif Vatne; Hans-Jørgen Smith; Sigurd Nitter-Hauge; Erik Fosse
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  78     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-27     Completed Date:  2005-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  502-5; discussion 505     Citation Subset:  AIM; IM    
Affiliation:
The Interventional Centre, Rikshospitalet University Hospital, N-0027 Oslo, Norway. per.kristian.hol@rikshospitalet.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina Pectoris / surgery
Coronary Angiography*
Coronary Artery Bypass*
Coronary Artery Bypass, Off-Pump
Female
Graft Occlusion, Vascular / prevention & control*,  radiography
Humans
Internal Mammary-Coronary Artery Anastomosis
Intraoperative Care*
Male
Middle Aged
Retrospective Studies
Surgical Procedures, Minimally Invasive

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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