Coronary Artery Bypass Grafting (CABG) Flashcards

The proximal anastomosis of a saphenous vein graft in conventional CABG is most commonly placed on:

Answer: The ascending aorta

Proximal vein graft anastomoses are most commonly placed on the ascending aorta, though no-touch aortic techniques are increasingly used to reduce embolic risk.

Intraoperative graft flow measurement using transit-time flowmetry is used to:

Answer: Verify graft patency and detect technical errors before chest closure

Transit-time flowmetry measures actual blood flow through each graft, identifying low-flow or pulsatility index abnormalities suggesting technical problems requiring revision.

Perioperative myocardial infarction after CABG is most often caused by:

Answer: Early graft occlusion or technical anastomotic failure

Early graft occlusion due to technical anastomotic issues, thrombosis, or spasm is the most common cause of perioperative MI after CABG.

Aspirin after CABG should be initiated postoperatively primarily to:

Answer: Improve saphenous vein graft patency and reduce cardiovascular events

Early aspirin initiation (within 6 hours postoperatively) improves vein graft patency by inhibiting platelet aggregation at anastomotic sites.

The hybrid coronary revascularization approach combines:

Answer: LIMA-to-LAD CABG with percutaneous coronary intervention (PCI) for non-LAD lesions

Hybrid revascularization uses the durable LIMA-LAD surgical graft for the LAD territory and PCI stenting for other vessels, combining the best of both approaches.

Which vessel is the preferred conduit when total arterial revascularization is planned for a bilateral CABG strategy?

Answer: Bilateral internal mammary arteries (BIMA)

Bilateral IMA grafting provides the highest long-term patency rates for total arterial revascularization, though it increases the risk of sternal wound complications in diabetics.