Related Experiment Video
Updated: Aug 4, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Early asymptomatic graft failure in coronary artery bypass grafting: a study based on computed tomography angiography
Zengqiang Han1, Guodong Zhang2, Yu Chen3
1Cardiac Surgery Department, Peking University People's Hospital, Beijing, 100044, China.
Insights
Early asymptomatic graft failure after coronary bypass grafting surgery (CABG) occurs in 4.71% of grafts. Female gender, composite grafting, high pulse index, and new postoperative atrial fibrillation are risk factors, while dual-antiplatelet therapy is protective.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Imaging
Background:
- Asymptomatic graft failure post-coronary artery bypass grafting (CABG) impacts patient outcomes.
- Cardiac computed tomography angiography (CTA) is an alternative to coronary angiography for detecting graft failure.
- Identifying early asymptomatic graft failure is crucial for patient management.
Purpose of the Study:
- To determine the rate of asymptomatic graft failure detected by CTA before hospital discharge.
- To identify independent predictors and risk factors associated with early asymptomatic graft failure after CABG.
Main Methods:
- Retrospective study of 955 grafts from 346 asymptomatic patients undergoing CTA post-CABG (July 2017 - Dec 2019).
- Grafts classified as patent or occluded based on CTA results.
- Logistic regression analysis performed at the graft level to identify predictors of occlusion.
Main Results:
- The overall asymptomatic graft failure rate was 4.71% (45/955 grafts).
- Independent risk factors for graft failure included female gender, composite grafting, higher pulse index (PI) values, and new postoperative atrial fibrillation (POAF).
- Early dual-antiplatelet treatment (aspirin and clopidogrel) demonstrated a protective effect against graft failure.
Conclusions:
- Early asymptomatic graft failure is linked to patient (female gender, POAF) and surgical factors (composite grafting, high PI).
- Dual-antiplatelet therapy with aspirin and clopidogrel may help prevent early graft failure.
- CTA is effective in detecting early asymptomatic graft failure in CABG patients.
Background:
Asymptomatic graft failure after coronary bypass grafting surgery (CABG) may have negative impact on the patients' short- and long-term outcomes. Cardiac computed tomography angiography (CTA) has been proved to be another choice to detect graft failure besides coronary artery angiography in several studies. We aimed to identify the rate and predictors of asymptomatic graft failure detected by CTA before discharge.
Methods And Results:
A total of 955 grafts of 346 consecutive asymptomatic patients who received CTA examination after CABGs were included in this retrospective study from July 2017 to Dec 2019. We divided 955 grafts into the patent group and occluded group by CTA results. Logistic regression model at graft-level were established to determine predictors of the early asymptomatic graft occlusion. The overall asymptomatic graft failure rate was 4.71% (45/955), and there was no difference between the arterial and venous conduits in different target territories (P > 0.05). The logistic regression at graft-level analysis showed that female (OR 3.181, CI 1.58-6.40, P = 0.001), composite grafting (OR 6.762, CI 2.26-20.28, P = 0.001), pulse index value (OR 1.180, CI 1.08-1.29, P < 0.001) and new postoperative atrial fibrillation (POAF) (OR2.348, CI 1.15-4.78, P = 0.018) were independent risk factors that affect graft failure, while early postoperative dual-antiplatelet treatment with aspirin and clopidogrel was a protective factor (OR 0.403, CI 0.19-0.84, P = 0.015).
Conclusions:
Early asymptomatic graft failure is associated with both patient and surgical factors including female gender, high PI value, composite graft strategy and the new POAF. However, the early dual- antiplatelet therapy with aspirin and clopidogrel may be useful for preventing graft failure.
More Related Videos
12:00Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:28Imaging Studies for Cardiovascular System V: CT
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...