Use of Various Configurations of Different Arterial Grafts in Total Arterial Revascularization

• Conditions: Coronary Syndrome; Coronary Disease; Coronary Artery Disease
• Interventions: Procedure: coronary artery bypass grafting surgery

• Registration Number: NCT05300178
• Lead Sponsor: Assiut University

Brief Summary

CABG is a difficult and very critical surgery , it is done to revascularize the myocardium in cases of cardiac ischemia . If the myocardium is still viable in selected patients then it is the treatment of choice with outstanding results . Indications of this operation are more than 50% diameter stenosis of the left main coronary artery, more than 70% diameter stenosis in proximal left anterior descending artery (LAD), more than 70% diameter stenosis in three major coronary vessels, ventricular septal defect related to myocardial infarction , papillary muscle rupture , free wall rupture , ventricular pseudoaneurysm , life-threatening ventricular arrhythmias, and cardiogenic shock. Multiple methods have evolved to achieve the best outcome .The revascularization process depend on two main graft either artery or venous , each has its advantage and disadvantage according to their elasticity , ability to deliver an adequate flow and sustain high blood pressure. Our focus is on the different configuration used for the revascularization by using the artery grafts only due to the superiority of the artery graft in comparison to the venous according to the outcomes and not the feasibility of the technique .It is recommended to begin with internal thoracic artery then saphenous vein if both failed then multiple conduits will be used . Bilateral internal thoracic artery grafting can be an optimal option for coronary artery bypass grafting ,but it's the long-term outcome is still under study.There is no accepted configuration of the anastomosis to be used in the multiple conduits .

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-02-24
• Status Verified: 2022-03
• Study First Submitted QC: 2022-03-18
• Last Update Submitted: 2022-03-18
• Study Start: 2022-03-22
• Primary Completion: 2022-03-22
• Study Completion: 2022-03-22
• Study First Posted: 2022-03-29
• Last Update Posted: 2022-03-29

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• All patients with multi-coronary vessel disease eligible for CABG surgery .

Exclusion Criteria

• 1. age more than 70 years 2. diabetic patient 3. single vessel disease 4. associated valvular disease 5. previous open heart surgery 6. hemodynamic unstability 7. Ejection fraction less than (40%)

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
multiple vessel disease	coronary artery bypass grafting surgery	patients with coronary artery disease will be revascularized by using different bypass configuration.

Primary Outcome Measures

Name	Time	Method
Effective revascularization.	Changes Baseline perfustion after 3 months by MRI

Secondary Outcome Measures

Name	Time	Method
Number of patient complicated by heart failure	changes in the base line heart rate after 24 hours post-operative