Intraoperative coronary graft assessment

Abstract

Intraoperative graft assessment in coronary artery bypass grafting is infrequently performed. Nevertheless, studies show an immediate graft closure rate of 5-9% and a 1-year closure rate of 20-30%. Coronary angiography is the 'gold standard' for graft assessment yet has been seldom employed because of logistical problems and image quality. Two methods, transit time flow measurement and intraoperative fluorescence imaging are simple, safe, and expeditious. Intraoperative graft failure detection rates of 2-5% have been reported. Early graft occlusion occurs frequently after coronary artery bypass grafting. Two relatively simple but underutilized methods of intraoperative graft assessment have been shown to be predictive of graft failure. Wider use of these techniques as well as wider availability of hybrid operating rooms, which will allow intraoperative coronary angiography, may reduce graft failure.