Progression from stenosis to occlusion in the proximal native coronary artery after coronary artery bypass grafting

Tanaka, Akihito; Ishii, Hideki; Oshima, Hideki; Shibata, Yohei; Tatami, Yosuke; Osugi, Naohiro; Ota, Terukazu; Kawamura, Y.; Suzuki, Susumu; Usui, Akihiko; Murohara, Toyoaki

doi:10.1007/s00380-015-0715-8

Cited by 9 publications

(5 citation statements)

References 13 publications

(22 reference statements)

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“…Cataldo et al found that the SVG patency at the end of postoperative first year was related to several angiographic factors, such as target vessel diameter and coronary territory of right coronary artery, rather than demographical characteristics of the patients [14]. SVG failure with the possible acceleration of atherosclerosis in native coronary arteries, ends up as "malign graft failure", an essential problem in the follow-up of CABG patients [4]. In our study, the presence of malign graft failures was low (3.8% of total grafted vessels).…”

Section: Discussionmentioning

confidence: 99%

“…Acceleration of CAD in preoperatively nonoccluded native coronary arteries, was identified as the responsible factor for the development of recurrent anginal attacks in various studies. Progression of native coronary arterial disease from preoperative stenosis to postoperative total occlusion is an important feature, especially in cases of graft failure [3,4]. De novo total occlusion of a priorly non-occluded native coronary artery in the long-term postoperative period is a problematic situation, because total occlusion in CABG patients generally have a more challenging nature than chronic total occlusions (CTO) in native coronary anatomy without CABG operation [5].…”

Section: Introductionmentioning

confidence: 99%

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Koroner Arter Bypass Greft Cerrahisi Hastalarının Nativ Koroner Arterlerinde Yeni Kronik Total Oklüzyon Gelişimi

et al. 2020

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ÖZAmaç: Koroner arter bypas greftleme (KABG) cerrahisi hastalarının postoperatif klinik takibinde preoperatif olarak tam tıkalı olmayan nativ koroner arterlerin kronik total oklüde (KTO) hale gelmesi sık görülse de, seyriyle ilgili veriler kısıtlıdır. Çalışmamızın amacı postoperatif dönemde nativ koroner arterlerde yeni KTO gelişim sıklığını ve bu konuda rol oynayan faktörleri araştırmaktır. Yöntem: Başkent Üniversitesi Hastanesi Alanya Uygulama ve Araştırma Merkezi'nde gerçekleştirilen tüm KABG operasyonları bilgisayar sisteminden tarandı ve postoperatif ilk 6 aylık dönemden sonra rekürren koroner anjiyografi (KAG) prosedürü uygulanan hastalar çalışma grubuna alındı. Rekürren KAG görüntüleri yeni KTO gelişimi açısından değerlendirildi ve nativ koroner arterlerde yeni KTO gelişimine yol açan demografik ve anjiyografik özellikler lojistik regresyon analizi kullanılarak test edildi. Bulgular: Rekürren KAG yapılmış olan 73 KABG hastası istatistiksel analize dahil edildi (Ortalama yaş 65.2 ± 9.8 yıl; erkek cinsiyet %76.7). Preoperatif olarak tam tıkalı olmayan ve greftlenmiş olan 218 nativ koroner arter incelendi ve 119'unda (%54.5) yeni KTO saptandı. Preoperatif proksimal darlığın ≥%90 olması 3 kat daha fazla yeni KTO gelişimi ile ilişkili bulundu (%67.8 vs. %22.2) (p<0.001). İkili antiplatelet tedavisinin nativ koroner arterlerin açıklığını koruyucu rolü olduğu tespit edildi (HR:-0.259; %95 CI:-0.475'den -0.017'ye; p=0.036). Sonuç: Nativ koroner arterlerde postoperatif yeni KTO gelişimi CABG hastalarında sık görülmektedir. Preoperatif darlığın daha ciddi olması ve ikili antiplatelet tedavinin yokluğu yeni KTO gelişimi için temel faktörler olarak bulundu.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Koroner Arter Bypass Greft Cerrahisi Hastalarının Nativ Koroner Arterlerinde Yeni Kronik Total Oklüzyon Gelişimi

et al. 2020

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“…Past research has shown that incomplete revascularization of the LAD mainly influences the 5-10 year mortality rather than early postoperative mortality [Dourado 2018;Lawrie 1982;Leviner 2018] because effective side branches or collaterals may compensate for the myocardial perfusion in ischemic heart disease for some period of time [Seiler 2013], after which, with the progression of stenosis [Pereg 2014;Tanaka 2016], the clinical symptoms and signs may deteriorate. In our study, the 5-year follow-up of the all-cause mortality and MCEs did not indicate any significant difference between the two groups in regard to those outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Diffuse Left Anterior Descending Artery Lesions on Outcomes of Coronary Artery Bypass Grafting

Tseng

Lin

et al. 2020

HSF

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Background: Diffuse coronary lesions adversely influence the outcomes of coronary artery bypass grafting (CABG). This study aimed to investigate the influence of diffuse left anterior descending artery (LAD) lesions on the outcomes of CABG. Methods: The data of 123 patients, who received elective isolated CABG with the left internal mammary artery bypassed to the LAD from January 2011 to June 2017, were collected. According to their lesions (≥50% diameter stenoses) ≤2cm or >2cm in the middle and distal segment of LAD, the patients were classified into a No Diffuse Lesion (NDL) group (69 patients) and a Diffuse Lesion (DL) group (54 patients). The rates of in-hospital mortality, 5-year all-cause mortality, and major cardiac events (MCEs) (i.e. myocardial infarction, angina, acute heart failure, and atrial fibrillation) were analyzed. Results: According to the univariate analyses, the NDL group had fewer diffuse left circumflex artery (LCX) lesions (P = .001) and higher ventricular fibrillation (Vf) after aortic de-clamping (P = .03) than the DL group. According to the multivariate analyses, the in-hospital and 5-year all-cause mortality rates of the two groups did not significantly differ (P = .80 and P = .59). Otherwise, the DL group had a trend toward more MCEs (hazard ratio = 2.07, P = .061), but the difference clearly was insignificant after adjusting for diffuse LCX lesions and Vf after aortic de-clamping (P = .104). Conclusions: The results demonstrated that diffuse LAD lesions did not influence the risks of in-hospital mortality, 5-year all-cause mortality, or MCEs after CABG.

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“…All these interventions may not only alleviate the symptoms but also decrease mortality in these patients. 7-12…”

Section: Discussionmentioning

confidence: 99%

Successful Retrograde Visualization and Recanalization of Chronic Ostial Occlusion of the Left Main Coronary Artery via a Saphenous Vein Graft With the Drilled Balloon Technique

Balaban

Elevli

2019

Clin Med Insights Case Rep

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We are representing a case of successful retrograde recanalization of a chronic ostial occlusive lesion of the left main coronary artery (LMCA) via a saphenous vein graft. A 70-year-old male patient, with a history of previous (3 years ago) coronary artery bypass surgery, was evaluated with coronary angiography because of his recent anginal symptoms. Left main coronary artery could not be visualized from the aortic root. It could be visualized with drilled balloon technique which was introduced retrogradely from a saphenous vein graft, and the chronic ostial lesion of the LMCA could be treated with balloon dilatation and stenting. Coronary occlusions can be treated retrogradely via the native collaterals and grafts. The coronaries that are not visualized with an antegrade fashion can be visualized with a retrograde way with the drilled balloon introduced through a patent graft. We could not find any publication about this technique on the web-based research. When encountered with a totally occluded ostial lesion of the LMCA, that cannot be visualized even from the aortic root, it may be tried to be visualized through a patent graft retrogradely. This is a safe and reliable method in patients with a total occlusion of the LMCA who also have a patent saphenous vein graft.

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Progression from stenosis to occlusion in the proximal native coronary artery after coronary artery bypass grafting

Cited by 9 publications

References 13 publications

Koroner Arter Bypass Greft Cerrahisi Hastalarının Nativ Koroner Arterlerinde Yeni Kronik Total Oklüzyon Gelişimi

Koroner Arter Bypass Greft Cerrahisi Hastalarının Nativ Koroner Arterlerinde Yeni Kronik Total Oklüzyon Gelişimi

The Influence of Diffuse Left Anterior Descending Artery Lesions on Outcomes of Coronary Artery Bypass Grafting

Successful Retrograde Visualization and Recanalization of Chronic Ostial Occlusion of the Left Main Coronary Artery via a Saphenous Vein Graft With the Drilled Balloon Technique

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