Document Detail

Value of magnetic resonance imaging, angiography, and fractional flow reserve to evaluate the left main coronary artery after direct surgical angioplasty.
MedLine Citation:
PMID:  17257974     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Direct surgical angioplasty of the left main coronary artery is aimed to restore a more physiologic blood flow through the left main coronary artery compared with conventional bypass surgery and allows subsequent percutaneous coronary interventions of more distal coronary lesions. Some data on anatomic evaluation with coronary angiography and magnetic resonance imaging (MRI) are known, and we conducted a study to report the physiologic evaluation. METHODS: Coronary angiography, MRI, and fractional flow reserve measurements were performed in 18 patients 8 years after direct surgical angioplasty of the left main coronary artery. RESULTS: At coronary angiography and MRI, a dilated funnel-shaped left main coronary artery was seen in all 18 patients, but both methods failed to demonstrate a flow-limiting lesion in the distal left main coronary artery in 1 patient. The functional severity was shown by fractional flow reserve measurement, and subsequently, this patient underwent repeated bypass grafting surgery. CONCLUSIONS: After long-term follow-up, 17 of 18 patients had an excellent result of direct surgical angioplasty of the left main coronary artery. MRI is a safe and noninvasive way to visualize the left main coronary artery after direct surgical angioplasty, but quantitative assessment of a lesion is not reliable. Fractional flow reserve measurements are mandatory to evaluate the hemodynamic properties of the left main coronary artery after direct surgical angioplasty.
Cornelis J Botman; Hans Post; Olaf Penn; Nico Pijls
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  490-4     Citation Subset:  AIM; IM    
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
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MeSH Terms
Coronary Angiography / standards*
Coronary Artery Disease / diagnosis,  physiopathology*,  surgery*
Coronary Circulation*
Coronary Vessels / pathology,  physiopathology,  surgery
Follow-Up Studies
Magnetic Resonance Imaging / standards*
Middle Aged
Postoperative Period
Severity of Illness Index
Treatment Outcome
Vascular Surgical Procedures*
Comment In:
Ann Thorac Surg. 2007 Feb;83(2):494-5   [PMID:  17257975 ]

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