Ischaemic heart disease Circulatory System Chronic ischaemic heart disease
Conditions
Interventions
Consented patients will undergo CABG surgery using TAG (experimental group) or LIMA/SV (control group) based on the randomisation assignment and followed for 6 months post surgery with coronary angiog
Sponsors
Capital Health Authority, New Halifax Infirmary (Canada)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Consecutive patients between the ages of 60 and 75 years of age*, either sex 2. Undergoing non-emergent isolated CABG surgery for 3 vessel coronary disease 3. Have not already been enrolled in another study *The average age of patients undergoing CABG surgery at the QEII is approximately 70 with 50% of patients between the age restrictions. The age limit of 75 is an attempt at increasing long-term follow-up of patients which would be limited in octogenarians.
Exclusion criteria
Exclusion criteria: 1. Scheduled to undergo emergency or emergency salvage surgery 2. Angiographically ungraftable coronary territories 3. Prior surgical coronary revascularisation 4. Evidence of varicose veins on pre-operative physical examination which would preclude the use of the greater saphenous vein as a graft conduit 5. Previous radiation treatment to their chest area (which would make the utility of internal mammary arteries questionable) 6. Relative contraindications to computed tomography (CT) angiography such as pregnancy, chronic renal insufficiency (creatinine greater than 120 umol/L), or allergy to contrast media
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Six-month graft patency in patients who undergo TAG compared to those who undergo conventional coronary artery revascularisation with LIMA/SV grafts. Grafts will be assessed as patent, occluded or stenosed greater than 50%. For grafts with sequentially supply more than one vessel, each inter-anastomotic segment will be assessed separately. | — |
Secondary
| Measure | Time frame |
|---|---|
| Rates of adverse cardiovascular events in patients who undergo TAG compared to those who undergo conventional coronary artery revascularisation with LIMA/SV grafts. Results will be reported separately and as composite outcomes. Adverse cardiovascular events will be defined as: 1. Short term event: in-hospital mortality and in-hospital morbidity: 1.1. All cause mortality with the cause of death recorded 1.2. Morbidity: peri-operative myocardial infarction, re-intervention (percutaneous coronary intervention [PCI] or CABG), low output syndrome, prolonged mechanical ventilation, sternal wound infection and prolonged length of hospitalisation 2. Late adverse cardiovascular events defined as: 2.1. All cause mortality 2.2. Readmission to hospital for cardiac reason | — |
Countries
Canada
Outcome results
None listed