The Graft Imaging to Improve Patency (GRIIP) clinical trial results

Singh, Steve K.; Desai, Nimesh D.; Chikazawa, Genta; Tsuneyoshi, Hiroshi; Vincent, Jessica; Zagorski, Brandon; Pen, Visal; Moussa, Fuad; Cohen, Gideon; Christakis, George T.; Fremes, Stephen E.

doi:10.1016/j.jtcvs.2009.09.048

Cited by 51 publications

(62 citation statements)

References 19 publications

(24 reference statements)

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“…Reported SV patency rates vary considerably, and early failure rate can be quite high. Investigators 11,23,24 have recently reported 11%, 20%, and 30% occlusion rates of SV grafts by 1 year. On the other hand, Hayward et al 20 found an 87% SV patency at 5 years in their protocol-driven study, which is a very unusual and rarely reported patency rate.…”

Section: Discussionmentioning

confidence: 99%

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Coronary Artery Bypass Grafting Using the Radial Artery

et al. 2012

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Background-Radial artery (RA) grafts are an attractive second arterial conduit after the left internal thoracic artery (LITA) for coronary artery bypass graft (CABG) surgery. However, long-term outcomes and the need for subsequent reintervention have not been defined. Methods and Results-We performed a retrospective cohort study of our single institution's 16-year experience with 1851 consecutive patients (average age, 58 years; 82% men, 36% diabetic) undergoing primary, isolated CABG with the LITA, RA, and saphenous vein as needed. Average grafts per patient were 3.8, with 2.4 arterial grafts per patient. Survival was determined using the Social Security Death Index. Grafts were nonpatent if they had a Ͼ50% stenosis, a string sign, or were occluded. Five patients (0.3%) died in hospital and 0.8% had a myocardial infarction, 1.1% a stroke, and 0.6% renal failure. Kaplan-Meier-estimated 1-, 5-, 10-, and 15-year survival was 99%, 96%, 89%, and 75%, respectively. Of the cohort, 278 symptomatic patients underwent cardiac catheterization at our institution an average of 5.0Ϯ3.8 years (range, 0.1-12 years) after CABG. Overall RA (nϭ420 grafts) patency was 82% and SV (nϭ364 grafts) patency, 47% (PϽ0.0001). LITA (nϭ287 grafts including 9 sequential grafts) patency was 85% and right internal thoracic artery (nϭ15 grafts) patency was 80% (Pϭ0.6). RA patency was not different from LITA patency (Pϭ0.3). Overall freedom from catheterization, percutaneous coronary intervention, and CABG was 85%, 97%, and 99%, respectively. Conclusions-RA grafting is a highly effective revascularization strategy providing excellent short and long-term outcomes with very low rates of reintervention. RA patency is similar to LITA patency and is much better than SV patency. RA grafting should be more widely utilized in patients undergoing CABG. (Circulation. 2012;126[suppl 1]:S170 -S175.)

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Section: Discussionmentioning

confidence: 99%

“…On the other hand, Hayward et al 20 found an 87% SV patency at 5 years in their protocol-driven study, which is a very unusual and rarely reported patency rate. Indeed, Singh et al 24 recently concluded that the incidence of SV graft failure remains high despite contemporary practice.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting Using the Radial Artery

et al. 2012

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“…Indocyanine green fluoroscopy and transit-time ultrasound flowmetry are validated and easy to use means of identifying graft errors and surgical correction intraoperatively [8,[15][16][17][18][19]. However, they pose potential risks to the patient by prolonging cross-clamp and cardiopulmonary bypass times, and they may theoretically could lead to poorer anastomosis quality and patency by inappropriate revision.…”

Section: Detection Of Graft Failurementioning

confidence: 99%

“…Surprisingly, it is observed in some studies that 25% to 34% of patients undergoing coronary reangiography for suspected early graft failure after CABG have patent grafts [4,11,18].This important finding suggests that early graft failure should be confirmed with re-angiography (if the hemodynamic status enables) instead of carrying out a blind reoperation.…”

Section: Treatment Optionsmentioning

confidence: 99%

Early graft failure after coronary artery bypass grafting: diagnosis and treatment

Türk

2016

Eur Res J

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Early postoperative graft failure after coronary artery bypass grafting (CABG) is still a significant problem that results in high morbidity and mortality. Different therapeutic options are available to manage this complication which include reoperation, balloon angioplasty, angioplasty along with stenting and conservative medical management. Herein, we review the existing literature in diagnosis and treatment options for overcoming early graft failure immediately following CABG.Eur Res J 2016;2(2):85-92

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“…Иссле-дованиями ряда авторов [4,6] было показано, что в тече-ние 1-й недели после операции выявляется окклюзия до 15% аутовенозных (АВШ) и до 8% маммаро-коронарных (МКШ) шунтов. Известно, что в подавляющем большин-стве случаев дисфункции шунтов, выявляемые в ранние сроки после операции, возникают вследствие техниче-ских ошибок или погрешностей при формировании ана-стомозов.…”

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Intraoperative indocyanine green angiography as a method assessing immediate results of coronary artery bypass grafting: possibilities and prospects of use

Семченко¹,

Andreev²,

Yavnyi³

et al. 2015

Kardiol. serdechno-sosud. khir.

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Ключевые слова: прямая реваскуляризация миокарда, ангиография с индоцианином зеленым.An experience of intraoperative qualitative assessment of the results of coronary artery bypass grafting using indocyanine green angiography is presented. The study included 34 patients with coronary artery disease (age 63±7.7 years). It was studied the patency of 96 coronary bypass grafts. The advantages, disadvantages and possibilities of indocyanine green angiography for assessment of blood flow in coronary bypass grafts were established. We revealed that intraoperative imaging technique with qualitative assessment of blood flow in coronary bypass grafts using indocyanine green angiography is safe, simple, reproducible and informative procedure.Keywords: direct myocardial revascularization, indocyanine green angiography.

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The Graft Imaging to Improve Patency (GRIIP) clinical trial results

Abstract: Routine intraoperative graft assessment is safe but does not lead to a marked reduction in graft occlusion 1-year after bypass grafting. The incidence of saphenous vein graft failure remains high despite contemporary practice and routine intraoperative graft surveillance.

Cited by 51 publications

References 19 publications

Coronary Artery Bypass Grafting Using the Radial Artery

Coronary Artery Bypass Grafting Using the Radial Artery

Early graft failure after coronary artery bypass grafting: diagnosis and treatment

Intraoperative indocyanine green angiography as a method assessing immediate results of coronary artery bypass grafting: possibilities and prospects of use

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