title: Cineangiographic intraoperative evaluation of venous grafts during coronary bypass surgery.
abstract: OBJECTIVE
  Evaluation of graft patency is an important component of coronary bypass surgery. In the present study, intraoperative cineangiography was performed in a cardiovascular hybrid operating room to evaluate anastomosis quality and patency of coronary venous grafts.
  
  
  METHODS
  This prospective study evaluated coronary bypass grafts in 34 patients between January 2012 and June 2012. Radiopaque material was administered into the grafts through a vessel cannula before the proximal anastomosis. Then, cineangiographic images were obtained using a mobile C-arm cineangiography system. The myocardial perfusion scintigraphy (MPS) of the patients was compared between preoperative and first month postoperative periods to assess graft function.
  
  
  RESULTS
  The localization of the grafts in the target vessel, structural status of the grafts, anastomosis line, and availability of the target vessel were easily evaluated. Angiographic defects were detected in two grafts (3%, n = 60) in two patients (6%, n = 34). Staining was observed in the distal myocardial segments of the saphenous vein grafts following the administration of radiopaque material. The procedure took eight minutes, on average (range, 5-14 minutes), and a mean of 15 mL (range, 10-35 mL) of opaque material was used. None of the patients developed intraoperative myocardial infarction, postoperative complications, or contrast material-induced renal failure. No mortality was observed. The distal myocardial segments of saphenous vein grafts were detected to be perfused 92% normally, 5% reversibly defective, and 3% irreversibly defective with postoperative MPS controls.
  
  
  CONCLUSIONS
  Cineangiographic graft evaluation in a hybrid operating room is a practical, safe, noninvasive, easily available, and easily applicable method.
authors.affiliation: Department of Cardiovascular Surgery, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey. nesruf@isnet.net.tr
authors.forename: Ufuk
authors.initials: U
authors.lastname: Aydin
authors.forename: Nesrin
authors.initials: N
authors.lastname: Aydin
authors.forename: Alper
authors.initials: A
authors.lastname: Gorur
authors.forename: Orhan
authors.initials: O
authors.lastname: Findik
authors.forename: Cagri
authors.initials: C
authors.lastname: Duzyol
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Ahmet Lutfullah
authors.initials: AL
authors.lastname: Orhan
authors.forename: Cevdet Ugur
authors.initials: CU
authors.lastname: Kocogullari
mesh_terms: D000328:Adult; D000368:Aged; D002932:Cineangiography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D014654:Vascular Patency / Q000502:physiology*; D014680:Veins / Q000637:transplantation*