Multidetector Computed Tomographic Angiography in Planning of Reoperative Cardiothoracic Surgery

Apur R. Kamdar, Telly A. Meadows, Eric E. Roselli, Eiran Z. Gorodeski, Ronan J. Curtin, Joseph F. Sabik, Paul Schoenhagen, Richard D. White, Bruce W. Lytle, Scott D. Flamm, Milind Y. Desai

Research output: Contribution to journalArticle

Abstract

Background: Redo cardiothoracic surgery is associated with increased morbidity and mortality compared with primary operations. Multidetector computed tomographic angiography (MDCTA) delineates the course of previous coronary artery bypass grafts (CABG) and proximity of mediastinal structures to the chest wall. We sought to determine if high-risk preoperative MDCTA findings were associated with greater use of preventive surgical strategies during redo cardiac surgery in patients with prior CABG. Methods: We studied 167 patients (mean age 69 ± 9 years, 79% men) with prior CABG, referred for redo cardiac surgery, who underwent contrast-enhanced MDCTA to assess CABG location and mediastinal relationship to chest wall. Preoperative risk was determined. Prevalence of high-risk MDCTA findings, use of preventive surgical strategies, frequency of severe intraoperative bleeding, and postoperative mortality were recorded. Results: Mean risk score was high (7.5 ± 3). High-risk MDCTA findings included proximity (

Original languageEnglish (US)
Pages (from-to)1239-1245
Number of pages7
JournalAnnals of Thoracic Surgery
Volume85
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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    Kamdar, A. R., Meadows, T. A., Roselli, E. E., Gorodeski, E. Z., Curtin, R. J., Sabik, J. F., Schoenhagen, P., White, R. D., Lytle, B. W., Flamm, S. D., & Desai, M. Y. (2008). Multidetector Computed Tomographic Angiography in Planning of Reoperative Cardiothoracic Surgery. Annals of Thoracic Surgery, 85(4), 1239-1245. https://doi.org/10.1016/j.athoracsur.2007.11.075