MEDICAL SCIENCES
KEEP CALM AND RECONSIDER GRAFT REVISION The impact of coronary stenosis for beating heart coronary artery bypass grafting Preoperative angiography in combination with intraoperative graft flow measurements may improve durability of coronary artery bypass grafts. However, native coronary flow might impair bypass graft flow based on stenoses’ severity, leading to inferior long-term outcomes. Intraoperative routine snaring of a coronary artery detects significant competitive flow, possibly intercepting unnecessary perioperative graft revisions. Frank R Halfwerk, Assistant Professor, Cardiac Surgery Innovations Lab University of Twente
The heart, inadequate blood supply, and revascularisation
The coronary arteries supply the heart itself with oxygen and nutrients. Severe narrowing of these coronaries (stenosis) might lead to chest pain or a heart attack. Myocardial revascularisation by either percutaneous coronary intervention or
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A SI A N H O S P I T A L & H EA LT HCA R E M A N AGE M E N T
coronary artery bypass graft (CABG) improves symptoms, quality of life and survival in these patients. A stenosis with a diameter reduction < 50 per cent is considered a mild stenosis, 50 – 70 per cent as moderate, and > 70 per cent as severe. Unfortunately, the degree of coronary stenosis can easily
IS S UE - 55, 2022
be overestimated and impacts short and long-term outcomes of CABG. A heart lung machine takes over the heart’s pumping function and gas transfer of the lungs during heart surgery. Major drawbacks, however, are a systemic inflammatory response, acute kidney injury or brain infarctions. For
