The intraluminal coronary shunts (ILS) in OPCAB allow easier, safer, more accurate anastomosis
and better myocardial protection by maintaining distal coronary perfusion during beating
heart coronary revascularization. This was retrospectively study on sixty patients at Maadi
Military Medical Campus who had OPCAB using ILS; Multislice CT and coronary angiography
were performed after one year of surgery to assess the graft patency. The total number
of grafts was 118, 60 were LIMA (50.8%) and 58 were SVG (49.2%). Post operatively seven
patients (11.7%) had MI, two patients (3.3%) had wound infection, one patient (1.7%) had
prolonged ventilation>24hours, and one patient (1.7) had perioperative intra- aortic balloon
pump.
By coronary angiography; 102/118 grafts (86.4%) were patent, 6 had significant stenosis
(>50%) and 10 grafts (8.5%) were totally occluded. BY CT angiography; 101-grafts (85.6%)
were patent, 7-grafts (5.9%) had significant stenosis and 10-grafts (8.5%) were totally occluded,
but without significant difference between results of coronary angiography, and CT angiography
(p>0.05).
The results by using ILS during OPCAB was safe and showed very much accepted graft patency
one year after OPCAB compared to the studies looked for graft patency after OPCAB
but using different methods to achieve bloodless field during anastomosis like snaring and
bulldogs, CT angiography is a good modality in terms of follow up after CABG it was a noninvasive
technique needs no hospital admission, short examination time and it has high sensitivity
and specificity.