title: Coronary graft patency after perioperative myocardial infarction: a study with multislice computed tomography.
abstract: A total of 55 consecutive patients who experienced perioperative myocardial infarction (MI) after coronary artery bypass grafting were studied using multislice computed tomography (MSCT) angiography to evaluate for graft patency. The MSCT detected acute graft occlusion in 23% grafts. Of the 55 patients, 40% patients had occluded grafts and perioperative MI in the area of the grafted vessels; remaining 60% had patent grafts with infarction in the area of the grafted vessels. Compared with the patients with patent grafts, those with occluded grafts had a higher blood sugar level. In addition, graft occlusion was higher in grafts with severe distal disease. Among the patients with patent grafts, luminal stenosis of the native vessels supplying the infarcted myocardium was higher than that in the native vessels supplying the non-infarcted myocardium. In conclusion, MSCT is feasible for the assessment of graft patency in the setting of perioperative MI. Graft occlusion is detected in less than half of the cases and usually occurs in the grafts with severe distal involvement and the patients with uncontrolled hyperglycemia. In patients with patent grafts, the severity of luminal stenosis of the native grafted vessel is the main predisposing factor for perioperative MI.
authors.affiliation: Department of Interventional Cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hosseinali
authors.initials: H
authors.lastname: Bassiri
authors.forename: Alireza
authors.initials: A
authors.lastname: Nematollahi
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Noohi
authors.forename: Jafar
authors.initials: J
authors.lastname: Hashemi
authors.forename: Marzieh
authors.initials: M
authors.lastname: Motevali
authors.forename: Nader
authors.initials: N
authors.lastname: Givtaj
authors.forename: Kamal
authors.initials: K
authors.lastname: Raissi
authors.forename: Majid
authors.initials: M
authors.lastname: Haghjoo
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D023903:Coronary Restenosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D059035:Perioperative Period; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency
chemical_list: D001786:Blood Glucose