Objective. To determine the possibilities and diagnostic value of the optical coherent tomography (OCT) in the assessment of the
coronary graft (CG) patency in combination with intraoperative coronary bypass angiography (ICBA).
Material and methods. From July 2017 until February 2018 an intraoperative OCT was performed in 52 patients, median age
62.3 ± 4.8 years, which underwent coronary artery bypass graft surgery (CABG). In total 144 conduits were applied in 52 patients
(median 2.3 ± 0.8). ICBA was performed in all patients, in 60 (41.7%) grafts additional OCT was performed with angiographic correlation.
Among 60 scanned grafts, 49 were veins and 11 – arteries (9 – internal thoracic artery, 2 – radial artery).
Results. Among 60 grafts scanned with OCT and ICBA 6 (10%) were patent with no pathological changes. In the remaining
54 (90%) grafts, specific OCT changes were registered, but only 24 were correlated with ICBA. This 24 cases included: large thrombi
in venous graft (VG) – in 10 cases; the disparity of VG and grafted coronary artery (more than 2) – in 8 cases; angiographic sign
of critical stenosis at the vein to vein anastomosis site – 1, VG stenosis due to the deformed venous valve at the site of various node
– in 2 case and left internal mammary artery (LIMA) stenosis due to vascular clip compression – in 3 cases. In other 30 grafts, we
registered only OCT findings: small parietal thrombi – in 7 VG; venous valve – in 17 VG, in 3 radial artery grafts a spontaneous annular
dissection was registered, venous side branch culprit – 3. Surgical revisions and repeated interventions were carried out only in
dysfunctions revealed by ICBA. Despite the fact that all patients were discharged from the hospital with no complications.
Conclusion. Intraoperative OCT is a new promising technique, which allows obtaining most detailed data about possible predisposal
factors of coronary graft failure in short and long-term follow up.
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About the authors
- Leo A. Bockeria, Academician of RAS and RAMS, Director, orcid.org/0000-0002-6180-2619
Karen V. Petrosyan, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-3370-0295
Ol'ga L. Bockeria, Dr. Med. Sc., Professor, Corresponding Member of RAS, Chief Researcher, orcid.org/0000-0002-7711-8520
Yuriy I. Buziashvili, Dr. Med. Sc., Academician of Russian Academy of Sciences, Head of Department
Vladimir V. Losev, Postgraduate, orcid.org/0000-0001-9677-7022
Aslan V. Karaev, Cand. Med. Sc., Junior Researcher, orcid.org/0000-0002-1587-0573
Evgeniy P. Golubev, Cand. Med. Sc., Junior Researcher, orcid.org/0000-0001-5354-937X
Inga V. Tetvadze, Cand. Med. Sc., Head Physician of V.I. Bourakovsky Institute of Cardiac Surgery, orcid.org/0000-0001-8730-2201