Why the study?
This study aimed to assess graft patency rates following CABG surgery using noninvasive CT angiography.
Does coronary endarterectomy combined with off-pump CABG maintain long-term graft patency compared to isolated off-pump CABG in patients with diffuse coronary artery disease?
Does coronary endarterectomy combined with off-pump CABG maintain long-term graft patency compared to isolated off-pump CABG in patients with diffuse coronary artery disease?
Coronary endarterectomy combined with off-pump CABG provides comparable 5-year graft patency and angina-free survival to isolated CABG in patients with diffuse coronary artery disease.
Similar five-year graft patency (~90%) with or without endarterectomy supports feasibility in diffuse CAD; leaves open need for randomized trials.
Background This study aims to assess the graft patency rate following coronary artery bypass graft (CABG) surgery using noninvasive CT angiography. Materials and methods A total of 68 patients were retrospectively evaluated with CT angiography (group I: 34 patients with coronary endarterectomy (CE) and group II: 34 patients without CE). CE was performed in multi-segmental diffuse coronary artery disease (CAD) or when calcified or extremely thick plaques made anastomosis troublesome. A team of two experts, an interventional radiologist and a cardiac surgeon, did the evaluations of graft patency rate. Results A total of 205 bypass grafts were evaluated in 68 post-CABG status patients (110 grafts in group I and 95 grafts in group II; moreover, 82 were arterial and 123 were venous grafts). Post CABG, CT angiography demonstrated a graft patency rate of about 90% in both study groups at five years follow up, which was statistically insignificant (P > 0.05) in terms of graft patency rate. Following CE, five-year angina-free survival rates were 89% and 91% in groups I and II, respectively. Conclusion CABG surgery with endarterectomy is reliable and effective. It achieves the desired surgical myocardial revascularization in patients with diffuse calcified CAD having no alternative options for adequate myocardial revascularization.
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Ranjan et al. (2022) studied this question.
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