Comparison of graft patency for off-pump and conventional coronary arterial bypass grafting using 64-slice multidetector spiral computed tomography angiography

Abstract

Off-pump coronary artery bypass graft surgery (OPCAB) has been performed for many years and its use is increasing frequently, but it remains an open question whether OPCAB provides similar patency to conventional coronary artery bypass graft (CCABG) surgery with cardiopulmonary bypass. The present study assessed the graft patency in patients that had coronary arterial bypass grafting (CABG) performed on-pump and off-pump. A total of 237 patients with CABG performed by a single surgeon were retrospectively studied, in which 100 patients underwent CCABG and 137 patients underwent OPCAB; the two groups were well matched according to relative factors and no significant differences were found in both groups. Postoperatively, systematic assessment on the graft patency of all the patients was conducted with 64-slice multidetector spiral computed tomography angiography (MSCTA) at one month, 1 year, 2 years, 3 years and 4 years, respectively, to provide 641 grafts for analysis. Patency of left internal mammary artery (LIMA) was higher than that of saphenous vein (SVG) in both groups; no significant difference was seen in LIMA patency and SVG patency in both groups. Results of 64-slice MSCTA indicate that OPCAB provides similar patency to CCABG surgery with CPB.

Robotic Total Arterial Off-Pump Coronary Artery Bypass Grafting: Seven-Year Single-Center Experience and Long-Term Follow-Up of Graft Patency

“…In addition, the results would be more objective and convincing if the SYNTAX score was included to quantify the complexity of coronary disease. Furthermore, despite our previous study [31] showing that CTA had similar efficacy to angiography in evaluating the graft patency and CTA was generally considered an accurate noninvasive alternative to it [14,15,24,[31][32][33], angiography was still considered the gold standard for the assessment of graft patency but only 1 in 10 patients was followed up with angiography in this study. In addition, approximately 7% of patients were clinically followed without angiography or CTA evaluation.…”

The Patency of Sequential and Individual Saphenous Vein Grafts after Off-pump Coronary Artery Bypass Grafting

“…Since 2005, we have used 64‐MSCT as a routine method to assess the patency of grafts. In addition, the patients who had symptoms of myocardial ischemia or 64‐MSCT indicated stenosis/occluding of the graft/anastomosis would undergo CAG 5 …”

“…In addition, the patients who had symptoms of myocardial ischemia or 64-MSCT indicated stenosis/occluding of the graft/anastomosis would undergo CAG. 5 Although the arterial grafts have superior long-term patency rates, especially for LIMA to LAD, SVGs are still needed in daily practice for CABG. Their mid-or long-term patency of an OPCAB surgery is affected by many factors, in which the impact of the grafting techniques (individual or sequential grafts) on the graft patency has not been reported to our knowledge.…”

“…The most distal anastomosis was arranged on a high‐quality vessel while poor quality ones were put in the middle position. Off‐pump techniques were described in a previous study 4,5 . The distal anastomosis on a sequential graft was done in end‐to‐side fashion and middle ones were done in side‐to‐side fashion.…”

“…Off-pump techniques were described in a previous study. 4,5 The distal anastomosis on a sequential graft was done in end-to-side fashion and middle ones were done in side-to-side fashion. Side-to-side anastomoses were performed in a crossing fashion and in a diamond-shape, and end-to side ones were done parallel to the native coronary vessel axis.…”