Odległa ocena pomostowania MIDCAB z wykorzystaniem tomografi i komputerowej
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2nd Department of Cardiology, Silesian Heart Centre, Medical University of Silesia, Katowice, Poland
Unit of Noninvasive Cardiovascular Diagnostics, Silesian Heart Centre, Medical University of Silesia, Katowice, Poland
1st Department of Cardiac Surgery, Silesian Heart Centre, Medical University of Silesia, Katowice, Poland
3rd Department of Cardiology, Silesian Heart Centre, Medical University of Silesia, Katowice, Poland
Corresponding author
Mariusz Skowerski   

MD Department of Cardiology Medical University of Silesia Silesian Heart Center Ziolowa 47 Street 40-635 Katowice, Poland Phone: +48 32 3598884 Fax: +48 32 2527407
Ann. Acad. Med. Siles. 2010;64:7-15
The patients (pts) who underwent minimally invasive coronary artery bypass (MIDCAB) are the population where the routine noninvasive diagnostic tests are insuffi cient for the proper follow-up. Multislice spiral computed tomography (MSCT) coronary angiography allows to detect atherosclerotic lesions within coronary arteries. However, its usefulness for bypass grafts patency assessment is not recognised well enough.

Aims of the study:
The aims of the study were the prospective evaluation of the cumulative rates of clinical outcome in pts who underwent MIDCAB and examination of the patency of the LIMA-LAD anastomosis in symptomatic patients in the 64-row MSCT.

Material and Methods:
176 pts (146 males, 30 females, aged 54±10 yrs) who underwent MIDCAB between 1999-2001 were followed-up for 5.5±0.8 years. MACE (major adverse cardiac events) and MAE (major adverse event) were collected. 44 pts with symptomatic exe rcise examination received MSCT evaluation.

43 pts (24%) had history of MACE and MAE. 29 pts (16%) of them had non-cardiac-surgery related events. Six pts (3.4%) died due to cardiac reasons. Six pts (3.4%) experienced myocardial infarction and in 25 pts (14.2%) coronary intervention had to be performed (in 4 pts within LAD and 2 within LIMA-LAD anastomosis). In 44 pts MSCT coronary angiography was performed. Total occlusion of LIMA-LAD anastomosis was diagnosed in 4 pts, confirmed by invasive coronary angiography. Two patients who had PCI of LIMA-LAD anastomosis during the follow-up had normal flow by connection in MSCT.

Long-term follow-up after MIDCAB revealed a relatively high rate of cardiovascular events, mainly not connected with surgical technique but with natural progression of the coronary disease. The new generation MSCT seems to be promising as means of assessment of bypass grafts patency.

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