Coronary disease & ACSResearch article
Coronary bypass surgery guided by computed tomography in a low-risk population
- Single-arm feasibility study
- central core laboratory
Authors' conclusion
CABG guided by CCTA is feasible and has an acceptable safety profile in a selected population of complex coronary artery disease.
Study context
- Population
- Patients with three-vessel and/or left main disease (mean anatomical SYNTAX score 43.6)
- Participants
- 114 patients
- Comparison
- Coronary computed tomography angiography (CCTA)-guided coronary artery bypass grafting (CABG) without knowledge of invasive coronary angiography (ICA)
- CCTA-guided CABGn = 114
- Outcome
- Feasibility: % of operations performed without access to ICA
Main finding
As reported in the abstract
Feasibility (operations performed without access to ICA)
Feasibility (unblinding ICA required in one case)
99.1% (95% CI 95.2%-100%)
Anastomosis patency on 30-day follow-up CCTA (primary safety endpoint; 102 patients [91.9%])
92.6%
Secondary outcomes
Agreement in revascularization planning
- ICA- vs CCTA-Heart Team concordance 82.9%, kappa
- 0.58 (95% CI 0.50-0.66)
- CCTA-Heart Team vs actual treatment 83.7%, kappa
- 0.61 (95% CI 0.53-0.68)
Safety
Major adverse cardiac and cerebrovascular (MACCE) and major bleeding · 30 days
- MACCE
- 7.2%
- Major bleeding
- 2.7%
Original publication
Coronary bypass surgery guided by computed tomography in a low-risk population. Eur Heart J. Published 7 April 2024. doi:10.1093/eurheartj/ehae199
Summarised from the published abstract; every number is checked against it