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Ann Thorac Surg 1999;68:2263-2266
© 1999 The Society of Thoracic Surgeons
a Division of Cardiovascular Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
b Department of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
c Division of Radiation Safety, Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
d Department of Cares, Children’s Hospital, St. Louis, Missouri, USA
Address reprint requests to Dr Peterson, Division of Cardiovascular Medicine, Washington University School of Medicine, Campus Box 8086, 660 South Euclid Ave, St. Louis, MO 63110
e-mail: lpeterso{at}imgate.wustl.edu
Background. Although saphenous vein graft (SVG) markers have been available for many years, they have not been widely used in coronary artery bypass graft (CABG) surgery. This is likely due to the paucity of data regarding the utility of these markers in postsurgery cardiac catheterization.
Methods. We performed a prospective study of all post-CABG patients undergoing cardiac catheterization at Barnes-Jewish Hospital over a 6-month period to test our hypothesis that SVG markers would have a beneficial effect on these procedures. Differences in total procedure (arterial) time, time to image only the SVGs, fluoroscopy time, amount of contrast used, number of aortotomies, and number of views required were compared in patients with and without markers.
Results. Post-CABG patients undergoing catheterization who had markers (n = 76) required significantly less total procedure time (p = 0.007), fluoroscopy time (p = 0.02), and contrast use (p = 0.008). Even after adjusting for the numbers of SVG ostia and numbers of cine views, patients with markers still required less catheterization and fluoroscopy time (p < 0.01, p < 0.02) and time to image only the SVGs (p < 0.05) than those without markers (n = 106).
Conclusions. SVG markers improve the efficiency of post-CABG catheterizations; they decrease the exposure of patients and cardiologists to ionizing radiation, and they decrease the exposure of patients to potentially toxic contrast agents. SVG markers are beneficial to the vast majority of post-CABG patients.
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