Related Experiment Videos
Intraoperative angiography for quality control in MIDCAB and OPCAB
Johannes Bonatti1, Michael Danzmayr, Thomas Schachner
1Department of Cardiac Surgery, Innsbruck University Hospital, 6020 Innsbruck, Austria. johannes.o.bonatti@uibk.ac.at
Summary
Intraoperative angiography for coronary artery bypass grafts (CABG) on beating hearts identified graft issues like spasm and stenosis. This technique provided valuable information, leading to improved surgical outcomes and no perioperative myocardial ischemic events.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Imaging
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
- On-pump and off-pump (beating heart) techniques are utilized for CABG.
- Ensuring graft patency and proper placement is crucial for successful outcomes.
Purpose of the Study:
- To evaluate the initial experience and utility of intraoperative angiographic assessment of coronary artery bypass grafts.
- To determine the effectiveness of intraoperative angiography in identifying complications during beating heart CABG.
- To assess the impact of intraoperative findings on surgical decisions and patient outcomes.
Main Methods:
- Intraoperative angiography was performed on 33 coronary artery bypass grafts in 23 patients undergoing beating heart surgery.
- Transfemoral angiography was utilized with an OEC 9800 mobile C-arm.
- Findings were correlated with surgical revisions and perioperative events.
Main Results:
- Eleven out of 33 grafts (33%) showed evidence of graft or target vessel spasm.
- Two grafts (6%) had severe stenosis, necessitating surgical revision.
- Angiography findings led to the placement of an additional bypass graft in one patient.
- No hospital mortality or significant perioperative myocardial ischemic events were observed.
Conclusions:
- Intraoperative angiography is a valuable tool for assessing coronary artery bypass grafts during beating heart surgery.
- This technique can identify critical issues such as spasm and stenosis, allowing for immediate surgical correction.
- Intraoperative angiography contributes to improved graft patency and potentially better long-term patient outcomes, with no perioperative ischemic events in this series.