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William Wijns - One of the best experts on this subject based on the ideXlab platform.
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surgery. Methods and Results—From 2006 to 2010, we retrospectively included in this registry 627 consecutive patients treated by coronary Artery Bypass graft surgery having at least 1 angiographically intermediate stenosis. In 429 patients, coronary Artery Bypass graft surgery was based solely on angiography (angiography-guided group). In 198 patients, at least 1 intermediate stenosis was grafted with an FFR ≤0.80 or deferred with an FFR >0.80 (FFR-guided group). The end point was major adverse cardiovascular events at 3 years, defined as the composite of overall death, myocardial infarction, and target vessel revascularization. The rate of angiographic multivessel disease was similar in the angiography-guided and FFR-guided groups (404 [94.2%] versus 186 [93.9%]; P=0.722). In the FFR-guided group, this was significan...
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surger...
Filip Casselman - One of the best experts on this subject based on the ideXlab platform.
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surgery. Methods and Results—From 2006 to 2010, we retrospectively included in this registry 627 consecutive patients treated by coronary Artery Bypass graft surgery having at least 1 angiographically intermediate stenosis. In 429 patients, coronary Artery Bypass graft surgery was based solely on angiography (angiography-guided group). In 198 patients, at least 1 intermediate stenosis was grafted with an FFR ≤0.80 or deferred with an FFR >0.80 (FFR-guided group). The end point was major adverse cardiovascular events at 3 years, defined as the composite of overall death, myocardial infarction, and target vessel revascularization. The rate of angiographic multivessel disease was similar in the angiography-guided and FFR-guided groups (404 [94.2%] versus 186 [93.9%]; P=0.722). In the FFR-guided group, this was significan...
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surger...
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multivessel distal sutureless off pump coronary Artery Bypass grafting procedure using magnetic connectors
The Annals of Thoracic Surgery, 2004Co-Authors: Filip Casselman, Massimo Meco, Frank Van Praet, Luc Foubert, Hugo VanermenAbstract:Abstract Proximal anastomotic devices for beating heart coronary Artery Bypass grafting (CABG) have been developed to avoid ascending aortic manipulation. Distal anastomotic devices may become an extremely useful tool to assist in enabling minimally invasive (robotic) multivessel CABG. As a transition phase toward this ultimate goal we have been using a distal anastomotic device for the left internal mammary Artery-left anterior descending Artery (LIMA-LAD) anastomosis. In addition we recently performed two off-pump coronary Artery Bypass procedures that were distally completely sutureless.
Frank Van Praet - One of the best experts on this subject based on the ideXlab platform.
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surgery. Methods and Results—From 2006 to 2010, we retrospectively included in this registry 627 consecutive patients treated by coronary Artery Bypass graft surgery having at least 1 angiographically intermediate stenosis. In 429 patients, coronary Artery Bypass graft surgery was based solely on angiography (angiography-guided group). In 198 patients, at least 1 intermediate stenosis was grafted with an FFR ≤0.80 or deferred with an FFR >0.80 (FFR-guided group). The end point was major adverse cardiovascular events at 3 years, defined as the composite of overall death, myocardial infarction, and target vessel revascularization. The rate of angiographic multivessel disease was similar in the angiography-guided and FFR-guided groups (404 [94.2%] versus 186 [93.9%]; P=0.722). In the FFR-guided group, this was significan...
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surger...
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multivessel distal sutureless off pump coronary Artery Bypass grafting procedure using magnetic connectors
The Annals of Thoracic Surgery, 2004Co-Authors: Filip Casselman, Massimo Meco, Frank Van Praet, Luc Foubert, Hugo VanermenAbstract:Abstract Proximal anastomotic devices for beating heart coronary Artery Bypass grafting (CABG) have been developed to avoid ascending aortic manipulation. Distal anastomotic devices may become an extremely useful tool to assist in enabling minimally invasive (robotic) multivessel CABG. As a transition phase toward this ultimate goal we have been using a distal anastomotic device for the left internal mammary Artery-left anterior descending Artery (LIMA-LAD) anastomosis. In addition we recently performed two off-pump coronary Artery Bypass procedures that were distally completely sutureless.
Volkmar Falk - One of the best experts on this subject based on the ideXlab platform.
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cumulative sum failure analysis for eight surgeons performing minimally invasive direct coronary Artery Bypass
The Journal of Thoracic and Cardiovascular Surgery, 2007Co-Authors: David Holzhey, M Mochalski, Stephan Jacobs, Friedrich W Mohr, Thomas Walther, Volkmar FalkAbstract:Objective Analysis of average and individual surgical performance for minimally invasive direct coronary Artery Bypass was used to enhance quality control for that operation. Methods A total of 1441 standard minimally invasive direct coronary Artery Bypass procedures performed from August 1996 to January 2006 were analyzed for mortality and 10 other major perioperative complications. Learning curves and assessment of perioperative outcome were calculated using descriptive statistics and cumulative sum observed minus expected failure analysis for 8 involved surgeons with a personal experience ranging from 27 to 443 procedures. Results The incidence of in-hospital mortality was 0.9% and compared favorably with the predicted mortality calculated by the logistic EuroSCORE (3.6%, P P Conclusions Minimally invasive direct coronary Artery Bypass has become a procedure with low mortality and low complication rates, but results are case-load and surgeon dependent. Cumulative sum analysis is a valuable method allowing for a breakdown of complication rates over time displaying individual surgeons' strengths.
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total endoscopic computer enhanced coronary Artery Bypass grafting
European Journal of Cardio-Thoracic Surgery, 2000Co-Authors: Volkmar Falk, Thomas Walther, Anno Diegeler, Jurgen Banusch, Jan Brucerius, Jorg Raumans, R Autschbach, Friedrich W MohrAbstract:Objective: In an effort to minimize access in coronary Artery Bypass (CAB) surgery, a total endoscopic approach using computer enhanced technology was developed. Methods: By July 1999 the da Vinci telemanipulation system (Intuitive Surgical, Mountain View, CA) was used in 66 patients with coronary Artery disease. In 12 patients undergoing routine coronary Artery Bypass grafting (CABG) (group 1) the internal thoracic Artery (ITA) to left anterior descending Artery (LAD) anastomosis was performed remotely using the system. In 32 patients (group 2) endoscopic dissection of the ITA was performed followed by a conventional minimally invasive direct coronary Artery Bypass (MIDCAB) operation. In 22 patients ( group 3) the complete operation was performed endoscopically through 4 ports (total endoscopic coronary Artery Bypass, TECAB). Port-Access cardiopulmonary Bypass with cardioplegic arrest was used for TECAB. Results: In group 1 the time for performing the ITA to LAD anastomosis was 17 ± 10 min. Mean graft flow was 38 ± 25 ml/min. One anastomosis leaked and was repaired manually. In group 2 in 31/32 patients (96%) the ITA harvest was successfully performed with the system at mean of 61 ± 27 min. There was a substantial learning curve associated with ITA take-down. In one patient a dissection caused insufficient free ITA graft flow which necessated additional vein grafting. Postoperative angiography demonstrated graft patency in all cases. In the TECAB group, the operation could be completed through four ports in 18 of the 22 patients (82 %) with operating times in the range 220-507 min. In four patients, elective conversion to a minithoracotomy was required due to failure to identify the LAD (1), bleeding from the anastomosis (1), grafting of a diagonal branch (1) and torsion of the pedicle (1). One patient required reoperation for bleeding from an ITA side-branch. Median intubation time was 13 h and stay on ICU and hospitalization were 20 h and 7 days, respectively. A 3-month follow-up angiography revealed patent grafts in all TECAB patients. Conclusion: Endoscopic ITA harvesting and performing of arterial anastomoses can be safely performed with the da Vinci system. TECAB is possible on the arrested heart with good functional results. However, a substantial learning curve has to be overcome which is reflected in long operation times and an initial significant conversion rate.
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minimally invasive coronary Artery Bypass surgery without extracorporeal circulation
The New England Journal of Medicine, 1997Co-Authors: Anno Diegeler, Thomas Walther, Volkmar Falk, Friedrich W MohrAbstract:To the Editor: The term “minimally invasive surgery” is currently used for several procedures in cardiac surgery.1–3 Coronary-Artery Bypass surgery on the beating heart without extracorporeal circu...
Gabor G Toth - One of the best experts on this subject based on the ideXlab platform.
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surgery. Methods and Results—From 2006 to 2010, we retrospectively included in this registry 627 consecutive patients treated by coronary Artery Bypass graft surgery having at least 1 angiographically intermediate stenosis. In 429 patients, coronary Artery Bypass graft surgery was based solely on angiography (angiography-guided group). In 198 patients, at least 1 intermediate stenosis was grafted with an FFR ≤0.80 or deferred with an FFR >0.80 (FFR-guided group). The end point was major adverse cardiovascular events at 3 years, defined as the composite of overall death, myocardial infarction, and target vessel revascularization. The rate of angiographic multivessel disease was similar in the angiography-guided and FFR-guided groups (404 [94.2%] versus 186 [93.9%]; P=0.722). In the FFR-guided group, this was significan...
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fractional flow reserve guided versus angiography guided coronary Artery Bypass graft surgery
Circulation, 2013Co-Authors: Gabor G Toth, Filip Casselman, Frederic De Vroey, Stylianos A Pyxaras, Luigi Di Serafino, Frank Van Praet, Carlos Van Mieghem, Bernard Stockman, Bernard De Bruyne, William WijnsAbstract:Background—Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary Artery Bypass graft surger...
