Safety of coronary arteriography in clinically stable patients following coronary bypass surgery

Gobel, Fredarick L.; Stewart, William J.; Campeau, Lucien; Hickey, Ann; Herd, J. Alan; Forman, Sandra; White, Carl W.; Rosenberg, Yves

doi:10.1002/(sici)1097-0304(199812)45:4<376::aid-ccd5>3.0.co;2-x

Cited by 35 publications

(23 citation statements)

References 25 publications

(50 reference statements)

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“…However, conventional angiography is the only reliable method to determine the postoperative patency of LITA in spite of its invasivity and well-known disadvantages (22).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

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Objective: The main purpose of this study was to assess the patency of left internal thoracic artery (LITA) graft by using color Doppler ultrasonography (CDUSG) and furthermore to determine the sensitivity and specificity of CDUSG for patency by using coronary angiography as the reference standard. Methods: This study is an observational cohort study on diagnostic accuracy that was held between August 2008 and October 2009. CDUSG was performed in 138 consecutive patients who had angina symptom or positive ischemic findings following coronary artery bypass surgery. LITA blood flow velocity at peak-systole (PSV), diastole (PDV) and end-diastole (EDV) was recorded. All patients were also assessed by coronary angiography for LITA graft patency. Statistical analysis was performed by using independent samples t-test, Mann-Whitney-U test, chisquare test and receiver operating curve analyses (ROC). Results: Seventy-eight of all patients had functional LITA grafts and 59 patients had dysfunctional LITA grafts according to CDUSG-derived parameters, whereas we cannot conclude about one patient's LITA graft functionality. The LITA grafts were visualized angiographically in all cases. Of all 138 patients, 60 patients had dysfunctional LITA grafts after angiographic evaluation. The ROC analyses showed that PDV (AUC=0.899, 95% CI 0.844 to 0.953; p<0.001) and EDV (AUC=0.900; 95% CI 0.847 to 0.953; p<0.001) values were also strongly associated with graft functionality. We found out that CDUSG predicts LITA graft functionality with a sensitivity and specificity of 100% and 98.4% respectively. The accuracy of the CDUSG was calculated as 99.3%. Conclusion: CDUSG is a reliable non-invasive method for assessment of LITA graft patency. (Anadolu Kardiyol Derg 2014; 14: 286-91)

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“…However, conventional angiography is the only reliable method to determine the postoperative patency of LITA in spite of its invasivity and well-known disadvantages (22).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

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“…7,10 All native coronary arteries and coronary artery bypass grafts were injected, usually through 7F catheters, in a suggested standardized sequence of views. 8 LMCA segments were oriented in the image plane and clearly seen in at least two different views. Additional studies performed to assess the reproducibility of readings and the repeatability of imaging indicated that the magnitude of variability was small and had negligible impact on the angiographic measurements.…”

Section: Angiographic Methodsmentioning

confidence: 99%

“…Although current trials may be more aggressive and attain lower LDL-C levels than the Post CABG Trial, the terms aggressive and moderate were retained to be consistent with previous publications. [1][2][3][5][6][7][8][9] …”

Section: See P 2635mentioning

confidence: 99%

Effect of an Aggressive Lipid-Lowering Strategy on Progression of Atherosclerosis in the Left Main Coronary Artery From Patients in the Post Coronary Artery Bypass Graft Trial

White¹,

Gobel²,

Campeau³

et al. 2001

Circulation

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Background-The Post Coronary Artery Bypass Graft Trial, designed to compare the effects of two lipid-lowering regimens and low-dose anticoagulation versus placebo on progression of atherosclerosis in saphenous vein grafts of patients who had had CABG surgery, demonstrated that aggressive lowering of LDL cholesterol levels to a mean yearly cholesterol level from 93 to 97 mg/dL compared with a moderate reduction to a level of 132 to 136 mg/dL decreased the progression of atherosclerosis in saphenous vein grafts. Low-dose anticoagulation did not affect progression. This secondary analysis tested the hypothesis that a similar decrease in progression of atherosclerosis would also be present in native coronary arteries as measured in the left main coronary artery (LMCA). Methods and Results-

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“…The American College of Cardiology Foundation and the American Society of Nuclear Cardiology guidelines found MPS to be 'appropriate' for this category of patients, without further explanation (2). However, the prognosis of patients with normal MPS is so favourable (2-4) that invasive procedures mean a stepping-up in risk, which tends to increase with age, comorbidities and the number of previous interventions (8,9,(24)(25)(26). Therefore, the clinical evaluation of an individual patient should be sufficiently accurate as to justify direct referral for catheterization and potential revascularization by reliably sorting out most patients with normal myocardial perfusion and insignificant coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

High probability of disease in angina pectoris patients: Is clinical estimation reliable?

Høilund-Carlsen¹,

Johansen²,

Vach

et al. 2007

Canadian Journal of Cardiology

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Safety of coronary arteriography in clinically stable patients following coronary bypass surgery

Cited by 35 publications

References 25 publications

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Effect of an Aggressive Lipid-Lowering Strategy on Progression of Atherosclerosis in the Left Main Coronary Artery From Patients in the Post Coronary Artery Bypass Graft Trial

High probability of disease in angina pectoris patients: Is clinical estimation reliable?

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