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Effect of sequential coronary artery bypass venous grafting on right ventricular functions assessed by tissue Doppler
G Ozerdem1, N Katrancioglu, B Candemir
1Department of Cardiovascular Surgery, Cag Hospital, Ankara, Turkey.
Insights
Sequential bypass grafting of the right coronary artery improved right ventricular diastolic function. This method, unlike single grafting, enhanced key echocardiographic measures, indicating better RV function post-surgery.
Area of Science:
- Cardiovascular Surgery
- Cardiac Imaging
- Vascular Physiology
Background:
- Coronary artery bypass graft surgery is a standard treatment for coronary artery disease.
- The impact of sequential bypass grafting for complete right ventricular revascularization on ventricular function requires further investigation.
Purpose of the Study:
- To evaluate the effect of sequential bypass grafting on right ventricular (RV) function using tissue Doppler echocardiography.
Main Methods:
- 35 coronary artery disease patients were divided into two groups: 20 receiving sequential grafts and 15 receiving individual grafts.
- Tissue Doppler echocardiography was used to assess RV function pre-operatively and one month post-operatively.
Main Results:
- Postoperative analysis revealed significant improvements in right ventricular diastolic function in the sequential grafting group.
- Key indicators such as the E wave and E/A ratio increased, while the A wave and isovolumic relaxation times decreased significantly.
Conclusions:
- Sequential complete revascularization of the right coronary artery demonstrated an improvement in right ventricular diastolic function.
- Individual grafting did not yield similar improvements in RV diastolic function.
Background:
Coronary artery bypass graft surgery is a well-known and proven method of treatment for coronary artery disease. A modification of this method is complete revascularisation of the right ventricle by sequential bypass grafting of the right coronary artery, the effects of which on ventricular function need to be clarified. We sought to determine the effect of the sequential bypass graft method on right ventricular (RV) function utilising tissue Doppler echocardiography.
Methods:
A total of 35 coronary artery disease patients (group A: 20 sequential grafts; group B: 15 individual grafts) were enrolled. Patients were examined pre-operatively with tissue Doppler echocardiography for RV function, and again postoperatively after the first month.
Results:
Pre-operatively, there were no significant differences with regard to demographics or basal echocardiographic findings. On the other hand, postoperative right ventricular diastolic function was found to have improved significantly as the right ventricular E wave and E/A increased (9.5 ± 1.6 vs 7.6 ± 2.7 cm/s, p = 0.009 and 1.4 ± 0.2 vs 0.9 ± 0.2, p ≤ 0.01, respectively), while the A wave and isovolumic relaxation times (6.8 ± 2.1 vs 8.3 ± 3.4 cm/s, p < 0.03 and 55.2 ± 11.9 vs 87.2 ± 16.2 ms, p < 0.001, respectively) decreased. Although the S-wave peak amplitude decreased in group A patients, it did not reach statistical significance.
Conclusions:
Sequential, but not single, complete revascularisation of the right coronary artery appeared to improve the diastolic function of the right ventricle.
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