Routine Intraoperative Completion Angiography After Coronary Artery Bypass Grafting and 1-Stop Hybrid Revascularization

Abstract

Routine completion angiography detected 12% of grafts with important angiographic defects. One-stop hybrid coronary revascularization is reasonable, safe, and feasible. Combining the tools of the catheterization laboratory and operating room greatly enhances the options available to the surgeon and cardiologist for patients with complex coronary artery disease.

Hybrid minimally invasive myocardial revascularization in multivessel coronary disease . Current status of the issue

“…При этом воз-можно выполнение первым этапом как ЧКВ, так и МКШ. Остается дискутабельным вопрос о по-следовательности выполнения этапов при гибрид-ном подходе, каждая из методик имеет свои пре-имущества и недостатки [41,42]. На наш взгляд, первоочередная реваскуляризация бассейна ПНА из мини-доступа имеет ряд преимуществ, среди них возможность ангиографического контроля маммарного шунта; хирургическое вмешатель-ство проводится без двойной дезагрегантной терапии с меньшим риском кровотечений с по-следующим ее назначением перед вторым эта-пом; реваскуляризация большого бассейна ПНА снижает риск дальнейшего ЧКВ.…”

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

“…Most of the cardiac surgeons experience addressing this problem was that occlusion of a graft was a constant finding in patients that suffers circulatory collapse early after CABG and survival after immediate re-operation is possible. This may lead one to the hypothesis, that if early graft failure and/or incomplete revascularization are the most common causes of myocardial ischaemia early after CABG, this should be diagnosed by angiography and treated by a re-intervention either re-CABG or PCI [11,20,21].…”

The Hybrid Operating Room

“…In a study designed and published by the Vanderbilt Heart and Vascular Institute (Zhao et al, 2009), routine intraoperative completion angiography performed in a fully functional hybrid operation room detected important defects in 97 of 796 (12% of the grafts) venous coronary artery bypass grafts in 366 adult patients (14% of the patients) with complex coronary artery disease. Their findings in completion angiography at the end of the operation included suboptimal anastomoses, poor lie of the venous bypass graft, and bypasses to not diseased vessels.…”