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- Open Access
Effect of myocardial Scar detected by Cardiac Magnetic Resonance on perfusion time and short term outcomes after Coronary Artery Bypass Graft Surgery
https://doi.org/10.1186/1532-429X-18-S1-P85
© Kancherla et al. 2016
- Published: 27 January 2016
Keywords
- Cardiac Magnetic Resonance
- Late Gadolinium Enhancement
- Myocardial Scar
- Cross Clamp Time
- Perfusion Time
Background
Myocardial viability assessment by late gadolinium enhancement (LGE) on Cardiac Magnetic resonance (CMR) is an important prognostic tool in patients undergoing CABG. We aim to evaluate the association of scar with surgical parameters and 30 day outcomes post CABG as defined by Society of Thoracic Surgeons (STS) database.
Methods
Patients who underwent LGE CMR between January 2003 and February 2010 <1 month prior to CABG were included. A standard 16 segment model was used for Left ventricular (LV) scar quantification. Patients were categorized into Scar group and No-scar groups. Perfusion time (PT), Cross clamp time (CCT), 30-Day mortality, Ventricular arrhythmia, duration of ventilation, prolonged ICU (ICU-LOS) and hospital stay (H-LOS) were obtained. Chi square test, t- test, Wilcoxon rank sum tests and multivariate regression analysis was used for data analysis.
Results
196 patients met the inclusion criteria. 185 CMR studies were available. The median time from CMR study to CABG surgery was 2 (1, 4) days. The mean age of the study population was 63.2 years (± 11.5). Seventy-two percent were male. History of prior MI was present in 64% of patients and prior CABG in 5.4% patients. Median LV ejection fraction was 38% (28, 52). Cardiopulmonary bypass was used in 118 patients (72%).
There were 133 patients (72%) in the scar group and 52 patients (38%) in the No-scar group. Compared with No-scar group, Scar group has higher proportion of men 78% Vs 56% (p = 0.002), History of prior MI 74% Vs 39% (P = 0.0001) and lower LVEF 39% Vs 46 (P = 0.038).
Perfusion time (70 ± 19 min Vs 60 ± 15 min, P = 0.01) and Cross clamp time (48 ± 14 min Vs 40 ± 13 min, P = 0.004) were significantly longer in Scar group. In multivariate model, number of vessels bypassed (p < 0.0001), presence of scar (p = 0.0075), Age (p = 0.047) and lower LVEF (p = 0.049) were independently associated with longer perfusion time. Number of vessels bypassed (p < 0.0001), presence of scar (p = 0.0009) were independently associated with longer cross clamp time. There was no significant difference in 30-Day mortality, arrhythmia, duration of ventilation, prolonged ICU and hospital stay.
Conclusions
Short Term Outcomes
Parameters | All patients Mean / Median(IQ)/% | No-scar Mean / Median(IQ)/% | Scar group Mean/Median(IQ)/% | P value |
|---|---|---|---|---|
Number of patients | 185 | 52 | 133 | |
Perfusion Time (min) | 67.3 (± 18.4) | 60.4 (± 14.9) | 69.8 (± 19.0) | 0.0129 |
Cross Clamp Time (min) | 45.98 (± 13.7) | 40.1 (± 12.5) | 48.3 (± 13.5) | 0.0041 |
Short term Mortality (%) | 4.9 (n = 9) | 5.8 | 4.5 | 0.71 |
Arrhythmias (%) | 13.0 | 15.4 | 12.0 | 0.54 |
Total Ventilator Hours | 9.1 (5.9, 19.3) | 9 (5.8, 17.0) | 9.7 (5.9, 19.8) | 0.84 |
Prolonged ICU-LOS (%) | 29.67 | 30.8 | 29.2 | 0.74 |
Prolonged H-LOS (%) | 16.2 | 17.6 | 15.6 | 0.74 |
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
