Intraoperative Changes in Regional Wall Motion: Can Postoperative Coronary Artery Bypass Graft Failure Be Predicted
Journal of Cardiothoracic and Vascular Anesthesia,

De Mey N et al. – In this retrospective study, regional wall motions abnormalities (RWMAs) detected with transesophageal echocardiography (TEE) were of limited value to predict early postoperative coronary artery bypass graft (CABG) failure.

Methods
  • Five thousand nine hundred ninety-eight patients who underwent coronary artery bypass graft (CABG) surgery.
  • An evaluation of RWMAs recorded with intraoperative TEE before and after cardiopulmonary bypass (CPB) in patients who had coronary angiography for suspected postoperative myocardial ischemia based on electrocardiogram (ECG), CK-MB, troponin T, hemodynamic compromise, low cardiac output, and malignant ventricular arrhythmia.
  • Sensitivity, specificity, positive and negative predictive values, odds ratio, 95% confidence interval, and chi-square analysis were used.

Results
  • Thirty-nine patients (0.7%) underwent early coronary angiography for the suspicion of early graft dysfunction.
  • Of the 32 patients with diagnosed early graft dysfunction, 5 patients (15.6%) had shown new intraoperative RWMAs as detected by TEE, 21 patients (65.6%) had no new RWMAs, no report was available in 5 patients (15.6%), and 1 examination (3.1%) was excluded because of poor imaging quality.
  • The sensitivity of TEE to predict graft failure was 15.6%, the specificity was 57.1%, and the positive predictive and negative values were 62.5% and 12.9%, respectively.
  • The odds ratio and 95% confidence interval was 0.1190 (0.0099-1.4257) when TEE was positive compared with coronary angiography.
  • No association was found between new RWMAs detected with TEE and graft failure as documented with coronary angiography (p=0.106).

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...

Your Unread Messages in Cardiology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Cardiology Articles

1 Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials Hypertension, September 29, 2014    Evidence Based Medicine    Review Article

2 Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation European Heart Journal, September 16, 2014    Clinical Article

3 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

4 Chemicals found in everyday fruits could minimise organ damage after heart attack and stroke University of Cambridge News, November 14, 2014

5 PCI versus CABG: a meta-analysis The Journal of Thoracic and Cardiovascular Surgery, November 13, 2014    Clinical Article

6 Statins and almonds to lower lipoproteins (the STALL study) Journal of Clinical Lipidology, November 17, 2014

7 ‘Big data’ approach helps pinpoint possible new stent drug to prevent heart attacks Stanford School of Medicine News, November 20, 2014

8 What the guidelines do not say: statin non-benefit groups Current Atherosclerosis Reports, November 20, 2014    Clinical Guideline    Clinical Article

9 Efficacy of atomoxetine versus midodrine for the treatment of orthostatic hypotension in autonomic failure Hypertension, November 25, 2014    Clinical Article

10 Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation International Journal of Cardiology, November 26, 2014    Clinical Article

11 Stroke outcomes among participants randomized to chlorthalidone, amlodipine or lisinopril in ALLHAT Journal of the American Society of Hypertension, November 4, 2014    Clinical Article

12 Thromboembolic risk in 16 274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy EP Europace, September 19, 2014    Clinical Article

13 Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents New England Journal of Medicine, November 19, 2014    Evidence Based Medicine    Clinical Article

14 Safety and efficacy of fibrate-statin combination therapy compared to fibrate monotherapy in patients with dyslipidemia: A meta-analysis Vascular Pharmacology, November 12, 2014    Clinical Article

15 The effect of indapamide versus hydrochlorothiazide on ventricular and arterial function in patients with hypertension and diabetes: Results of a randomized trial American Heart Journal, October 1, 2014    Clinical Article

16 Meta-analysis on risk of bleeding with apixaban in patients with renal impairment The American Journal of Cardiology, November 21, 2014    Evidence Based Medicine    Review Article    Clinical Article

17 Bare metal stent versus paclitaxel eluting stent for intermediate length femoropopliteal arterial lesions (BATTLE trial): study protocol for a randomized controlled trial Full Text Trials, November 18, 2014    Free full text    Evidence Based Medicine    Clinical Article

18 Efficacy of HMG-CoA reductase inhibitors in the prevention of cerebrovascular attack in 1016 patients older than 75 years among 4014 type 2 diabetic individuals International Journal of Cardiology, November 7, 2014    Clinical Article

19 Effect of the natural sweetener, steviol glycoside, on cardiovascular risk factors: A systematic review and meta-analysis of randomised clinical trials European Journal of Preventive Cardiology, November 26, 2014    Evidence Based Medicine    Review Article

20 A systematic review of statin-induced muscle problems in clinical trials American Heart Journal, October 7, 2014    Review Article

Indexed Journals in Cardiology: American Heart Journal, American Journal of Cardiology, Circulationn, Heartmore