The experience of incorporating computed tomography of the chest as a routine pre-operative investigation for patient undergoing coronary artery bypass graft

Journal Contribution ResearchOnline@JCU
Carelli, Matheus;Ramponi, Fabio;Shah, Pallav;Emeto, Theophilus I.;Yadav, Sumit
Iyke Emeto
Abstract

Objective: Since 2018, in our institution, we adopted computed tomography (CT) of the chest as a routine pre-operative before CABG. We aimed to determine its impact on the rate of peri-operative CVA and surgical approach. Method: We retrospectively analyzed the data of 548 patients who underwent isolated CABG at the Townsville University Hospital, between 2015 and 2019. The data was obtained from a prospectively maintained regional registry. Two cohorts were formulated based on whether they had a CT chest as part of their preoperative work-up. Results: The total number of peri-operative strokes observer were four (0.77%), three (1.33%) in the Pre-op CT cohort and one (0.31%) in the No Pre-op CT cohort (p=0.311). The difference in the mortality rate between the group is statistically insignificant (Pre-op CT: 5 (2.23%) vs No Pre-op CT: 3 (0.93%) p=0.283). The three patients from the pre-op CT group who developed peri-operative strokes had severe calcification of the aortic arch and/or ascending aorta. The surgical approach was modified in 26 patients due to the findings of the pre-op CT. Those changes were composed of On-Pump beating heart CABG (14 patients) and Off-pump CABG with or without partial Cross-clamp or the aorta (12 patients). Conclusion: Overall, this study reinforces the finding of current literature, that pre-op CT scan should be performed in high-risk patients. The findings of the pre-op CT scans influenced dramatically the surgical approach. CT scans are a simple tool that allows surgeons to better plan a surgical strategy for an individual patient.

Journal

ANZ Journal of Surgery

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Volume

91

ISBN/ISSN

1445-2197

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Issue

S1

Pages Count

1

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Publisher

Wiley-Blackwell

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DOI

10.1111/ans.16805