CT Angiographic Evaluation of Graft Patency Rate Following Coronary Endarterectomy with OPCABG in Bangladesh

Asit B. Adhikary, Redoy Ranjan

Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

Date, time and location: 2018.05.25 13:30, Congress Hall, 2F–A

Abstract

BACKGROUND:

The aim of this study is to assess the graft patency rate following coronary endarterectomy in patients with diffuse coronary artery disease using noninvasive computed tomography (CT) angiography.

METHODS:

A total of 135 patients were prospectively evaluated with CT angiography (Group-1: 60 patients with Coronary endarterectomy and Group-2:75 patients without Coronary endarterectomy).Coronary Endarterectomy (CE) was performed in multi-segmental diffuse CAD, or when calcified or extremely thick plaque making anastomosis troublesome.The evaluations of graft patency rate were done by interventional radiologists and cardiac surgeon.

RESULTS:

Total 410 bypass grafts were evaluated in 135 post CABG status patients (182 graft inGroup-1 and 228 graft in Group-2;158 were arterial and 252 venous graft). Post CABG, CT angiography demonstrate graft patency rate 90.8% in Group-1 and 91.2% in Group-2 at 5 years follow up.The sensitivity, specificity, positive and negative predictive values for CT angiographic evaluation in detecting graft stenosis were 91%, 99%, 90%, and 99%, respectively.However, for graft occlusion, all values were 100%.Following CE, five year’s survival rate was 89.48% and86.37% were free from angina at follow-up of 5 years.No statistically significant difference (P <0.05) was found between two group in terms of graft patency rate.

CONCLUSION:

Coronary endarterectomy with OPCABG is reliable and accomplishes complete surgical revascularization in patients with diffuse CAD; when there is no other alternative for adequate myocardial revascularization.