Intra-operative assessment of coronary artery bypass grafts is recommended as best practice to reduce technical errors and ensure operative outcomes rival those of percutaneous coronary intervention.
Does intraoperative assessment of bypass grafts reduce technical errors and improve outcomes in patients undergoing CABG?
Intraoperative verification of CABG grafts is recommended as best practice to reduce technical errors and optimize surgical outcomes.
PURPOSE OF REVIEW: The coronary artery bypass graft (CABG) operation is one of the few remaining operations/interventions on diseased arteries that are not routinely verified during or immediately after the procedure. This review answers the 'how', 'when' and 'why' of intraoperative CABG assessment. RECENT FINDINGS: More recent than new literature on this topic, is the increased interest in quality assurance of CABG. This is most likely due to reports in the last 5 years suggesting CABG superiority to percutaneous coronary intervention (PCI) for improved mid-term and long-term outcomes; for example, for patients with diabetes mellitus (Freedom Trial by Farkouh in 2012), and for patients with SYNTAX score ≥ 33 (SYNTAX Trial by Mohr in 2013). Possibly CABG is re-emerging from the era-of-better-and-better-stents and is now deemed worthy of improvement. SUMMARY: In order to fully compliment PCI, the operative major adverse cardiac event rate of CABG must rival that of PCI. In order to reduce technical errors, it is best practice to perform intra-operative assessment of bypasses, especially since we have the tools.
Teresa M. Kieser (Mon,) conducted a review in Coronary artery disease requiring CABG. Intraoperative CABG assessment was evaluated. Intra-operative assessment of coronary artery bypass grafts is recommended as best practice to reduce technical errors and ensure operative outcomes rival those of percutaneous coronary intervention.
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