Transient internal mammary artery graft stenosis on early angiography: navigating pitfalls in hybrid myocardial revascularization

Per Lehnert; Troels Thim; Lars Jakobsen; Michael Mæng; Evald Høj Christiansen; Ivy Susanne Modrau

doi:10.25270/jic/24.00025

Transient internal mammary artery graft stenosis on early angiography: navigating pitfalls in hybrid myocardial revascularization

Per Lehnert, Troels Thim, Lars Jakobsen, Michael Mæng, Evald Høj Christiansen, Ivy Susanne Modrau

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

OBJECTIVES: Left internal mammary artery (LIMA) graft stenoses detected at early coronary angiography may be reversible and consequently prompt unnecessary graft revision. We aim to investigate the frequency, natural course, and clinical significance of internal mammary artery graft stenosis upon early angiography in patients undergoing hybrid myocardial revascularization.

METHODS: In this retrospective sub-study of the Coronary Hybrid Revascularization Study, we compared graft appearance, ie, stenosis degree and flow, on early (in-hospital) and scheduled follow-up coronary angiography after 1 year. We assessed the change in graft patency using the Fitzgibbon classification (grade A: unimpaired runoff; grade B > 50% stenosis; grade O: occlusion), as well as graft association with adverse events (death, myocardial infarction, stroke, and repeat revascularization) at up to 5-year follow-up.

RESULTS: We report clinical follow-up data for all 131 patients included in the Coronary Hybrid Revascularization Study. Change in graft patency was analyzed in 86 patients with satisfactory visualization of the LIMA graft on early and follow-up coronary angiography. All LIMA grafts were patent at discharge and follow-up. Twenty-seven of 37 (73%) grade B graft stenoses at early angiography resolved to grade A during follow-up of median 12 months (range, 8-83 months) after surgery. Angiographically significant graft stenoses at early coronary angiography were not associated with adverse clinical outcome up to 5-year follow-up.

CONCLUSIONS: Our results suggest that the majority of clinically silent LIMA graft stenoses resolve during follow-up and are not associated with adverse clinical outcomes.

Original language	English
Journal	The Journal of invasive cardiology
Volume	36
Issue	7
ISSN	1042-3931
DOIs	https://doi.org/10.25270/jic/24.00025
Publication status	Published - Jul 2024

Keywords

Coronary Angiography
Coronary Artery Bypass
Graft Patency
Grafting
Hybrid Myocardial
Revascularization

Access to Document

10.25270/jic/24.00025

Cite this

@article{b6147e7f86044aac933bc9974c293922,

title = "Transient internal mammary artery graft stenosis on early angiography: navigating pitfalls in hybrid myocardial revascularization",

abstract = "OBJECTIVES: Left internal mammary artery (LIMA) graft stenoses detected at early coronary angiography may be reversible and consequently prompt unnecessary graft revision. We aim to investigate the frequency, natural course, and clinical significance of internal mammary artery graft stenosis upon early angiography in patients undergoing hybrid myocardial revascularization.METHODS: In this retrospective sub-study of the Coronary Hybrid Revascularization Study, we compared graft appearance, ie, stenosis degree and flow, on early (in-hospital) and scheduled follow-up coronary angiography after 1 year. We assessed the change in graft patency using the Fitzgibbon classification (grade A: unimpaired runoff; grade B > 50% stenosis; grade O: occlusion), as well as graft association with adverse events (death, myocardial infarction, stroke, and repeat revascularization) at up to 5-year follow-up.RESULTS: We report clinical follow-up data for all 131 patients included in the Coronary Hybrid Revascularization Study. Change in graft patency was analyzed in 86 patients with satisfactory visualization of the LIMA graft on early and follow-up coronary angiography. All LIMA grafts were patent at discharge and follow-up. Twenty-seven of 37 (73%) grade B graft stenoses at early angiography resolved to grade A during follow-up of median 12 months (range, 8-83 months) after surgery. Angiographically significant graft stenoses at early coronary angiography were not associated with adverse clinical outcome up to 5-year follow-up.CONCLUSIONS: Our results suggest that the majority of clinically silent LIMA graft stenoses resolve during follow-up and are not associated with adverse clinical outcomes.",

keywords = "Coronary Angiography, Coronary Artery Bypass, Graft Patency, Grafting, Hybrid Myocardial, Revascularization",

author = "Per Lehnert and Troels Thim and Lars Jakobsen and Michael M{\ae}ng and Christiansen, {Evald H{\o}j} and Modrau, {Ivy Susanne}",

note = "The authors thank members of the Hybrid Coronary Revascularization Study Group at Aarhus University Hospital: Per H. Nielsen, Christian J. Terkelsen, Steen D. Kristensen, Hans E. B{\o}tker, Anne K. Kaltoft, Lars R. Krusell, Jens F. Lassen, Henning S. Kelb{\ae}k, Lone K. Andersen, and Leif Thuesen. We are grateful to Professor Erik T. Parner (Department of Biostatistics, Aarhus University) for statistical advice, and to research secretary Helle Bargsteen for her support.",

year = "2024",

month = jul,

doi = "10.25270/jic/24.00025",

language = "English",

volume = "36",

journal = "The Journal of invasive cardiology",

issn = "1042-3931",

publisher = "H M P Communications, LLC",

number = "7",

}

Transient internal mammary artery graft stenosis on early angiography: navigating pitfalls in hybrid myocardial revascularization. / Lehnert, Per ; Thim, Troels ; Jakobsen, Lars et al.
In: The Journal of invasive cardiology, Vol. 36, No. 7, 07.2024.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Transient internal mammary artery graft stenosis on early angiography

T2 - navigating pitfalls in hybrid myocardial revascularization

AU - Lehnert, Per

AU - Thim, Troels

AU - Jakobsen, Lars

AU - Mæng, Michael

AU - Christiansen, Evald Høj

AU - Modrau, Ivy Susanne

N1 - The authors thank members of the Hybrid Coronary Revascularization Study Group at Aarhus University Hospital: Per H. Nielsen, Christian J. Terkelsen, Steen D. Kristensen, Hans E. Bøtker, Anne K. Kaltoft, Lars R. Krusell, Jens F. Lassen, Henning S. Kelbæk, Lone K. Andersen, and Leif Thuesen. We are grateful to Professor Erik T. Parner (Department of Biostatistics, Aarhus University) for statistical advice, and to research secretary Helle Bargsteen for her support.

PY - 2024/7

Y1 - 2024/7

N2 - OBJECTIVES: Left internal mammary artery (LIMA) graft stenoses detected at early coronary angiography may be reversible and consequently prompt unnecessary graft revision. We aim to investigate the frequency, natural course, and clinical significance of internal mammary artery graft stenosis upon early angiography in patients undergoing hybrid myocardial revascularization.METHODS: In this retrospective sub-study of the Coronary Hybrid Revascularization Study, we compared graft appearance, ie, stenosis degree and flow, on early (in-hospital) and scheduled follow-up coronary angiography after 1 year. We assessed the change in graft patency using the Fitzgibbon classification (grade A: unimpaired runoff; grade B > 50% stenosis; grade O: occlusion), as well as graft association with adverse events (death, myocardial infarction, stroke, and repeat revascularization) at up to 5-year follow-up.RESULTS: We report clinical follow-up data for all 131 patients included in the Coronary Hybrid Revascularization Study. Change in graft patency was analyzed in 86 patients with satisfactory visualization of the LIMA graft on early and follow-up coronary angiography. All LIMA grafts were patent at discharge and follow-up. Twenty-seven of 37 (73%) grade B graft stenoses at early angiography resolved to grade A during follow-up of median 12 months (range, 8-83 months) after surgery. Angiographically significant graft stenoses at early coronary angiography were not associated with adverse clinical outcome up to 5-year follow-up.CONCLUSIONS: Our results suggest that the majority of clinically silent LIMA graft stenoses resolve during follow-up and are not associated with adverse clinical outcomes.

AB - OBJECTIVES: Left internal mammary artery (LIMA) graft stenoses detected at early coronary angiography may be reversible and consequently prompt unnecessary graft revision. We aim to investigate the frequency, natural course, and clinical significance of internal mammary artery graft stenosis upon early angiography in patients undergoing hybrid myocardial revascularization.METHODS: In this retrospective sub-study of the Coronary Hybrid Revascularization Study, we compared graft appearance, ie, stenosis degree and flow, on early (in-hospital) and scheduled follow-up coronary angiography after 1 year. We assessed the change in graft patency using the Fitzgibbon classification (grade A: unimpaired runoff; grade B > 50% stenosis; grade O: occlusion), as well as graft association with adverse events (death, myocardial infarction, stroke, and repeat revascularization) at up to 5-year follow-up.RESULTS: We report clinical follow-up data for all 131 patients included in the Coronary Hybrid Revascularization Study. Change in graft patency was analyzed in 86 patients with satisfactory visualization of the LIMA graft on early and follow-up coronary angiography. All LIMA grafts were patent at discharge and follow-up. Twenty-seven of 37 (73%) grade B graft stenoses at early angiography resolved to grade A during follow-up of median 12 months (range, 8-83 months) after surgery. Angiographically significant graft stenoses at early coronary angiography were not associated with adverse clinical outcome up to 5-year follow-up.CONCLUSIONS: Our results suggest that the majority of clinically silent LIMA graft stenoses resolve during follow-up and are not associated with adverse clinical outcomes.

KW - Coronary Angiography

KW - Coronary Artery Bypass

KW - Graft Patency

KW - Grafting

KW - Hybrid Myocardial

KW - Revascularization

UR - http://www.scopus.com/inward/record.url?scp=85201454699&partnerID=8YFLogxK

U2 - 10.25270/jic/24.00025

DO - 10.25270/jic/24.00025

M3 - Journal article

C2 - 38489570

SN - 1042-3931

VL - 36

JO - The Journal of invasive cardiology

JF - The Journal of invasive cardiology

IS - 7

ER -

Transient internal mammary artery graft stenosis on early angiography: navigating pitfalls in hybrid myocardial revascularization

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this