ABSTRACT
Saphenous vein graft (SVG) failure is a common finding in patients following coronary artery bypass graft (CABG) surgery. In the literature SVG failure rates have been reported from 25 to over 50% within 10 years. Although common, it remains unclear to what extent SVG failure affects clinical outcome, due to differences in definition, patient selection and follow-up. Particularly the lack of agreement on a universal definition makes comparisons between studies, and therefore generalizability of associations with outcomes, challenging. We suggest using a definition of SVG failure that is based on imaging as well as clinical parameters, that includes reporting SVG failure on both graft and patient level. The use of non-invasive imaging may help improve follow-up rates, and provide a more accurate picture of the real incidence and clinical impact of SVG failure. Given the lack of supportive evidence showing a consistent association between SVG failure and major adverse cardiovascular events, SVG failure should not be considered a valid surrogate endpoint at this time.
Subject(s)
Coronary Artery Bypass , Graft Occlusion, Vascular , Myocardial Infarction/epidemiology , Saphenous Vein/transplantation , Coronary Angiography , Graft Occlusion, Vascular/complications , Graft Occlusion, Vascular/diagnostic imaging , Graft Occlusion, Vascular/epidemiology , Humans , Incidence , Myocardial Infarction/etiology , Postoperative Complications , Vascular PatencyABSTRACT
Chronic atrial fibrillation affects over 2.2 million people and is associated with complications including heart failure, stroke, and exercise intolerance. Since drug therapy and cardioversion have been only partially successful in restoring sinus rhythm, surgical procedures were developed for medically refractory atrial fibrillation (1). We report a case of successful left atrial radiofrequency ablation for chronic atrial fibrillation in a patient who had a large secundum atrial septal defect.
