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Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
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Intraoperative angiography leads to graft revision in coronary artery bypass surgery

Per Kristian Hol1, Per Snorre Lingaas, Runar Lundblad

  • 1The Interventional Centre, Rikshospitalet University Hospital, N-0027 Oslo, Norway. per.kristian.hol@rikshospitalet.no

The Annals of Thoracic Surgery
|July 28, 2004
PubMed

Insights

Intraoperative angiography identified and enabled revision of 4.2% of coronary artery bypass grafts, preventing potential occlusion. This quality assessment improves surgical outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Graft anastomosis quality is crucial in coronary artery bypass surgery.
  • Intraoperative angiography is a tool for assessing graft quality during surgery.

Purpose of the Study:

  • To quantify the on-table revision rate for coronary artery bypass grafts using intraoperative angiography.

Main Methods:

  • Intraoperative angiography was performed on 427 grafts in 186 patients undergoing coronary artery bypass surgery.
  • Surgical approaches included on-pump (34%), off-pump sternotomy (49%), and minimally invasive direct coronary artery bypass grafting (MIDCAB) (17%).
  • On-table revisions were possible, with follow-up angiography at a mean of 346 days.

Main Results:

  • Eighteen of 427 grafts (4.2%) required revision based on intraoperative angiography findings.
  • Revision rates varied by surgical approach: 1.1% for on-pump, 6.4% for off-pump sternotomy, and 6.5% for MIDCAB.
  • All revised grafts were successfully treated, with 17 patent at 1-year follow-up.

Conclusions:

  • Intraoperative angiography effectively identifies grafts at risk of occlusion.
  • Implementing intraoperative quality assessment in coronary artery bypass surgery can enhance patient outcomes.
Abstract

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