Long-term Graft Patency Outcomes of LIMA-LAD Post-CABG Surgery Based on iFR Measurements.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Ischaemic Heart Disease
- Sponsor
- Prakash Punjabi
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Graft patency
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
The expected outcome of better and improved patency of bypass grafts and its direct relation to pre-operative iFR measurements of stenosis as compared to direct visual physiology of stenosis in the coronary angiogram.
To establish the correlation between the use of intracoronary physiology and improved graft patency at 12 months for patients undergoing CABG surgery.
It is a minimum of 28 and a maximum of 100 patients single-centre proof or concept/ observational study/ pilot study.
Detailed Description
Patients suffering from coronary artery disease undergo coronary artery bypass grafting surgery (CABG) as the standard of care. The selection of which vessels to bypass is usually at the discretion of the surgeon forming an opinion based on the pre-operative angiographic imaging. Intra-coronary physiology (iFR measurements) is more accurate to determine the level of damage to the coronary arteries; however, currently it is not used for CABG pre-assessment, but only for percutaneous intervention also known as stenting as it has been shown to improve outcomes. Although, the use of intracoronary physiology has not been extensively studied or validated in patients undergoing CABG. Patients with multi-vessel coronary artery disease (CAD) who are planned for surgical revascularization with coronary artery bypass grafting (CABG), will have iFR measurement taken during invasive coronary angiography as part of standard care, they will undergo CABG and will have echocardiography at 3 months and computed tomography coronary angiography (CTCA) at 12 months. Early graft failure will be assessed by the presentation of any clinical symptoms, major adverse cardiovascular and cerebrovascular events (MACCE) and echocardiography at 3 months. The endpoint will be graft patency as assessed by CT coronary angiography at 12 months. Anticipated recruitment is 12-24 months. Follow-up with echocardiography at 3 months and a CTCA at 12 months. Quality of Life questionnaire will be completed by the patient at 3 and 12 months during the follow-up appointment. Patients will continue on optimal medical therapy. Clinic visit and quality of life scale questionnaires will be recorded at 3 and 12 months and echocardiography will be assessed at 3 months. Graft patency at 12 months will be assessed with a CT coronary angiography.
Investigators
Prakash Punjabi
Consultant Cardiothoracic Surgeon
Imperial College Healthcare NHS Trust
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Graft patency
Time Frame: 12 months
The primary endpoint will be graft patency as assessed by CT coronary angiography at 12 months.
Secondary Outcomes
- Incident of Death (cardiovascular)(12 months)
- Composite of MACE (MI, Death, stroke, repeat revascularisation)(12 months)
- Incidence of Myocardial infarction(12 months)
- Incidence of Stroke(12 months)
- Left ventricular function at 3 months with an echocardiography(3 months)
- Quality of Life Questionnaire(3 and 12 months)
- Any episode of reintervention(12 months)
- Incidence of Death (all-cause)(12 months)