Intraoperative angiography leads to graft revision in coronary artery bypass surgery

Ann Thorac Surg. 2004 Aug;78(2):502-5; discussion 505. doi: 10.1016/j.athoracsur.2004.03.004.


Background: Graft anastomosis quality in coronary artery bypass surgery can be assessed by intraoperative angiography. The aim of the present study was to quantify the on-table revision rate initiated by intraoperative angiography.

Methods: Intraoperative angiography was carried out in 186 patients undergoing coronary artery bypass surgery, with a total of 427 grafts. The operation was performed on-pump in 34%, off-pump through a sternotomy in 49%, and as a minimally invasive direct coronary bypass grafting (MIDCAB) procedure in 17%. The angiography was performed intraoperatively while the patients were still in general anesthesia, with the possibility for on-table revision. Follow-up angiography was carried out after a mean of 346 days.

Results: Eighteen of 427 grafts (4.2%) were revised due to the findings at intraoperative angiography. Revision rate after on-pump surgery was 1.1%, after off-pump through a sternotomy 6.4%, and after MIDCAB 6.5%. In 6 patients the lesions were located at the distal anastomoses and in 12 patients in the conduit. All but one was successfully revised, and at 1-year follow-up all these 17 grafts were patent.

Conclusions: Intraoperative angiography saves a potential number of grafts that otherwise could have been occluded. An increased implementation of intraoperative quality assessment in coronary artery bypass surgery can lead to improved outcome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angina Pectoris / surgery
  • Coronary Angiography*
  • Coronary Artery Bypass*
  • Coronary Artery Bypass, Off-Pump
  • Female
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / prevention & control*
  • Humans
  • Internal Mammary-Coronary Artery Anastomosis
  • Intraoperative Care*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Retrospective Studies