Document Detail


Quality control after total arterial revascularisation: multislice computer tomography cannot replace coronary angiography.
MedLine Citation:
PMID:  18193369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Coronary angiography is regarded as the gold standard in evaluating graft patency, Multi-slice CT (MSCT) which enable rapid imaging of cardiac structures, including coronary arteries may be a less invasive technique. Therefore in our institution a prospective pilot study was performed combining these procedures. PATIENTS AND METHODS: Starting from July 2004 a study was done with 13 patients. They received TAR using composite left internal thoracic artery (LITA) and left radial artery (RA) as T-graft. Intra-operative angiography was performed in these patients to confirm graft patency. Follow-up control (9-21 months) was performed with exercise Ergometry and 64 slides MSCT. RESULT: Mean procedure time for intra-operative angiography was 13.7 +/- 7.3 min and mean fluoroscopy time was 6.2 +/- 4.6 min. In one patient, RA-marginal artery side to side anastomoses was stenosed and had to be revised. And in another, there was a kinking of the LITA and was corrected. At follow-up, exercise ergometry showed no signs of angina or ECG-changes in all patients. MSCT showed occluded radial artery grafts in two patients. In two other patients interpretation was difficult due to resolution reasons. In all patients the LITA graft was patent. CONCLUSION: The intra-operative graft angiography can be performed in patients undergoing TAR easily. MSCT can be used for post-operative less-invasive angiography with limitations in patients with small graft/coronary diameters and arrhythmias. However, this study shows that an interdisciplinary cooperation is a new possibility toward quality control during and after TAR.
Authors:
Malakh Shrestha; Nawid Khaladj; Christoph Bara; Jürgen Weidemann; Michael Maringka; Ruoyu Zhang; Axel Haverich; Christian Hagl
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2008-01-14
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  97     ISSN:  1861-0692     ISO Abbreviation:  -     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-26     Completed Date:  2009-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  371-5     Citation Subset:  IM    
Affiliation:
Dept. of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Shrestha.Malakh.Lal@mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography*
Female
Humans
Male
Middle Aged
Myocardial Revascularization / methods*,  standards
Pilot Projects
Prospective Studies
Quality Assurance, Health Care*
Tomography, X-Ray Computed / methods*
Vascular Patency

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