X-RAY EVALUATION OF CALCIFICATION OF THE DISTAL SECTIONS OF TARGET

CORONARY ARTERIES TO DETERMINE THE SURGICAL APPROACH OF CORONARY

ARTERY BYPASS GRAFTING

 

Shiryaev A.A.¹, Mayorov G.B.¹, Vasiliev V.P.¹, Galayutdinov D.M.¹,

Goncharenko D.N.², Fedotenkov I.S.¹, Akchurin R.S.¹, Ternovoy S.K.¹

Purpose. To compare of the diagnostic capabilities of coronary angiography  (CAG) and  multi-slice cardiac computed tomography for the evaluation of coronary arteries distal calcification  in patients directed to the coronary artery bypass surgery (CABG).

Material and methods. The study included 106 patients with calcification of the target coronary arteries identified during the CAG. The analysis of angiographic data with the determination of the severity of calcification, as well as the assessment of the severity of coronary lesion by the SYNTAX score and the purposefully crafted «index of diffuse disease» (IDD) was carried out by three independent experts. All patients underwent coronary artery MSCT with the assessment of lesion and vessel specific coronary artery calcium score to evaluate the severity and localization of calcification to determine the operation technique of performing surgical intervention.  The severity of the coronary arteries lesions was evaluated   by the scale of the average segment involvement score.

Results. A statistical analysis of the indicators of the IDD scale and the Vessel specific Agatston score established a positive correlation of high crowding (r = 0.806) according to the Cheddock scale. A comparative analysis of X-ray methods using the severity scale of coronary artery lesions and the number of involved distal calcification segments  showed the following data: lesion of 1-2 segments by CAG was observed in 4 patients, by MSCT - 0 (p <0.05); lesion > 8 segments by CAG - 8 patients, by MSCT - 20 patients (p <0.05). The average segment involvement score by MSCT was higher than by CAG and were 8.15 ± 2.7 versus 5.9 ± 2.9 (p <0.05).

Conclusion. Significant advantages of MSCT were noted for detailing the lesion and determining surgical tactics of CABG compared with CAG in patients with distal coronary artery calcification, as well as the effectiveness of including MSCT in the preoperative examination of this category of patients.

 

1 - A.L. Myasnikov of National medical

research center of

cardiology.

2 - I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, Russia..

 

Keywords: coronary artery calcification, multislice computed tomography, coronary artery bypass grafting.

 


Corresponding author:  Mayorov G.B., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Shiryaev A.A., Mayorov G.B., Vasiliev V.P., Galayutdinov D.M., Goncharenko D.N., Fedotenkov I.S., Akchurin R.S., Ternovoy S.K. X-ray evaluation of calcification of the distal sections of target coronary arteries to determine the surgical approach of coronary artery bypass grafting. REJR 2020; 10(4):97-107. DOI:10.21569/2222-7415-2020-10-4-97-107.

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Received:       03.07.20 Accepted:     19.08.20