Postoperative Coronary Artery Research Articles

Analysis of Pre-and Post-operative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Acute Kidney Injury After Coronary Artery Bypass Grafting Surgery

Acute Kidney Injury (AKI) remains a common complication of post-operative Coronary Artery Bypass Grafting (CABG)related to high morbidity and mortality. Systemic inflammation has been known as a part of the pathogenesis of acute kidneyinjury. This study aimed to analyze the Neutrophil Lymphocyte (N/L) ratio and Platelet Lymphocyte (P/L) ratio in post-operativeAKI. This research was a retrospective study involving 76 patients who underwent CABG surgery in Dr. Wahidin SudirohusodoCentral Hospital, Makassar, between January 2015 and May 2019. The diagnosis of AKI was based on Kidney Disease ImprovingGlobal Outcomes (KDIGO) 2012 criteria. The N/L ratio and P/L ratio were calculated respectively as a neutrophil count ratio tolymphocyte count and platelet count to lymphocyte count. Twenty-five (32.9%) patients developed AKI in the first 48 hours ofthe post-operative period. There was no difference in pre-operative N/L ratio and the P/L ratio between AKI and non-AKIgroups (p > 0.05). Both ratios increased after surgery and were significantly different between the two groups with higher meanratio in non-AKI (16.93±9.16 vs. 21.86±11.13, p=0.040 and 239,24±184,36 vs. 314,49±143,73, p=0.011). Both pre-operativeand post-operative N/L ratio and P/L ratio could not distinguish AKI after CABG.

Laughter in Combination with Yoga Exercises: Changes in Psychological Distress and Quality of Life in Patients with Coronary Heart Disease (CHD)

Background: Emotional distress (such as depression, anxiety, and stress) predisposes individuals to the risk of heart disease and impact on patient's prospective recovery period. Targeting those factors through psychological intervention can accelerate the healing process. Simulated laughter as a form of therapy in combination with yoga exercise and diaphragmatic breathing exercise may lead to mental and physical relaxation and elevate the quality of life. Objectives: This study aimed to measure any psychological distress changes (anxiety, depression, and stress) and simultaneously determine any alterations in the quality of life after intervening laughter-yoga therapy in CHD patients. Methods: We conducted an experimental clinical trial which administered a pretest-posttest questionnaire. Also, collected data at a ten-session therapy while patients were referring to the rehabilitation program for their postoperative Coronary artery bypass grafting (CABG) at Tehran Heart Centre. Experimental Participants (N=150) and the control group (N=150) were selected by the convenient sampling method. Subjects participated in 45-minute Laughter Yoga(LY) sessions conducted by an instructor specialised in laughter yoga. A clinical psychologist administered the anxiety, stress, and depression scale (DASS) and Quality of Life Questionnaire (SF-36). We interpreted its eight subscales separately, such as measuring physical function, physical role, physical pain, general health, vitality, emotional role, mental health social function and quality of life. Results: Depression in the pretest group was 17.49, which degraded to 4.02 in the posttest; anxiety in the pretest test group was 17.44, which diminished to 4.20 in posttest; also, the mean of stress in the groups showed that in the trial group, the quantity degraded from 16.09 to 3.89. However, those values remained consistent in pre-posttest in the control group. Furthermore, the mean of the quality of life (QoL) in the experimental group was 227.2 in the pretest, which was 605.33 in the posttest, and significantly increased. Accordingly, the impact of laughter-yoga on physical function, physical role, physical pain, general health, vitality, emotional role, mental health, social performance is reported. Conclusion: Current research has shown that coronary heart disease (CHD) patients suffer considerably from emotional disturbances (depression, anxiety and stress) accordingly decreased quality of life. Intervening the laughter-yoga treatment by alleviating psychological distress is positively helpful to heal CHD patients. Ultimately, suggestions for further research are offered.

The Effect of Glycosylated Hemoglobin Oil Post-Operative Coronay Artery Bypass Graft Surgery Outcomes

Abstract Background type 2 diabetes mellitus (T2DM) is a known risk factor of coronary artery disease (CAD). Cardiovascular disease is the leading cause of death in T2DM patients. Antecedent to and associated with epicardial coronary artery stenosis, T2DM patients develop abnormal microvascular function in systemic circulatory beds. Glycosylated hemoglobin (HgbA1c) has been established as a risk factor for T2DM patients developing microvascular atherosclerosis. Aim of the Work the Effect of Glycosylated Hemoglobin Control on Post-Operative Coronary Artery Bypass Graft Surgery Outcomes this is widely across studies and patient populations, and this heterogeneity must be controlled when using the literature to indicate safety. Patients and Methods this study was performed on 60 patients, who underwent CABG at Cardiothoracic Academy from January 2018 to August 2018. Retrospective Descriptive Observational Study. Cardiothoracic Academy, Ain Shams University Hospitals. Study Period: 6 Months. This study included all patients operated upon for CABG in our hospital and who fulfilled our inclusion and exclusion criteria. Results preoperative HbA1c is not the only predictor of surgical site infection after cardiac surgery in diabetic patients and in patients with previously undiagnosed diabetes. Baseline HbA1c 8.6 was associated with the higher risk of chest wound infection. Interestingly, in this series. Conclusion this study shows that the incidence of chest and leg wound infections are significantly related to the value of the glycosylated hemoglobin and rate of infection increases with poor control of diabetes and from this study we recommend measurement of glycosylated hemoglobin value for all patient undergoing cardiac surgery.

Effectiveness of quick relaxation technique on pain associated with chest tube removal among postoperative coronary artery bypass grafting patients in a Tertiary Care Hospital, Delhi

The current burden of coronary artery disease in India is >32 million. Chest tube removal (CTR) is a common procedure in critical care units and post coronary care units and is associated with moderate-to-severe pain. The pain management protocols remain unsatisfactory for most patients and researchers recommend the development and introduction of new protocols. Even with pharmacological management, most patients remember chest removal as a painful and discontented moment. Advanced practice nurses remove chest tubes most often. The aim of the present study was to assess the effectiveness of quick relaxation technique (QRT) on CTR for reducing the pain levels experienced by patients and also adopting it as a routine practice in cardiac surgical units. An experimental design was used. Sixty patients who were posted for coronary artery bypass grafting (CABG) were selected using purposive consecutive sampling method and randomly allotted to the experimental and control group. QRT was implemented to experimental group patients along with the regular protocol before drain removal. Control group patients underwent the regular protocol followed in surgical intensive care unit. The structured assessment tool was developed and used for data collection, which consisted of demographic data, information related to chest tube and numerical rating scale for pain assessment. Out of the 60 patients majority were in the age group of 60–70 years and majority were male in the control and experimental groups. Control group had mean post-procedure pain score of 5.1 ± 1.14, whereas the experimental group had mean pain score of 3.7 ± 1.05. QRT was highly effective in reducing the pain level on chest tube drain removal of post-CABG patients (Unpaired t-test value of 5.6394 with df 58, P

The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation

BackgroundThe aim of this study was to determine if there was a difference between coronary reimplantation after neoaortic reconstruction and open coronary reimplantation technique in arterial switch operation (ASO).MethodsA total of 236 patients who underwent ASO from March 1994 to August 2018 were enrolled in this study. Multivariate analysis was performed for postoperative early mortality. Patients were divided into the open coronary reimplantation and coronary reimplantation after neoaortic reconstruction groups. The 30-day mortality, intraoperative and postoperative coronary artery (CA) revisions, CA–related late morbidity and mortality, and early and late neoaortic valve regurgitations after ASO were compared between the two groups.ResultsOverall postoperative early mortality was 7.2% (17/236). Patients who underwent open coronary reimplantation had higher early mortality as compared with those who underwent coronary reimplantation after neoaortic reconstruction. Risk factors for postoperative early mortality from multivariate analysis were cardiopulmonary bypass time and open coronary reimplantation. There was a higher incidence of CA–related late mortality or morbidity in the open coronary reimplantation group. The open coronary reimplantation group had a higher incidence of intraoperative or postoperative CA revision. There were no differences in the incidence of mild or more neoaortic valve regurgitation at discharge or in the 5-year freedom from mild or more neoaortic valve regurgitation.ConclusionsCA reimplantation after neoaortic reconstruction yields better results in mortality and intraoperative or postoperative CA–related problems in ASO without increasing postoperative neoaortic valve regurgitation.

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Effect of Diabetes Mellitus on Complication Rates of Coronary Artery Bypass Grafting

Previous studies have shown that diabetes mellitus (DM) is a risk factor for postoperative coronary artery bypass grafting (CABG) complications. More contemporary studies are needed to guide revascularization decisions in DM patients. We performed a single-center study of patients who underwent CABG. Patients with no DM were compared with patients with DM, subgrouped according to whether or not DM was treated with insulin before admission (Insulin and No Insulin Groups). Multivariable logistic regression was used to determine whether DM was a significant predictor of mortality, combined postoperative events, and specific postoperative complications after controlling for other predictive clinical variables. Of 11,590 consecutive patients who underwent CABG, 5,013 (43%) had DM and 6,577 (57%) had no DM. Of the patients with DM, 3,433 (68%) were not treated with insulin and 1,580 (32%) were treated with insulin before admission. Multivariable logistic regression analyses showed that DM was not significantly associated with in-hospital mortality or combined postoperative events after considering other clinical variables. The No Insulin Group was significantly associated with stroke, and the Insulin Group was significantly associated with surgical site infection and new renal failure. In conclusion, this study of consecutively treated CABG patients shows that DM is not a predictor of in-hospital mortality or combined in-hospital postoperative events after adjusting for other clinical factors. DM is a predictor of permanent stroke, surgical site infection, and new renal failure. These findings may help with case selection and management of DM patients undergoing CABG.

Efficacy and safety of preoperative Ticagrelor loading treatment in emergency percutaneous coronary intervention for acute ST-segment elevation myocardial infarction

Objective To observe the safety and efficacy of preoperative Ticagrelor loading in emergency percutaneous coronary intervention(PCI)for acute ST-segment elevation myocardial infarction(STEMI). Methods A total of 213 patients with acute STEMI before undergoing emergency PCI were randomly divided into Ticagrelor group(n=105)receiving 180 mg Ticagrelor loading dose, then 90 mg twice daily and Clopidogrel group(n=108) receiving 600 mg of Clopidogrel, then 75 mg once daily.Emergency PCI postoperative coronary artery TIMI flow grade and the change of incidence of no reflow, platelet aggregation rate, incidence of bleeding events and the incidence of major adverse cardiovascular events(MACE)were compared between two groups. Results The rate of no-reflow was 7.6%(8 cases)in Ticagrelor group, and 16.7%(18 cases)in Clopidogrel group(χ2=3.26、P=0.030). Platelet aggregation rates at 1 h and 24 h after treatment were (55.6±4.3)% and(48.6±4.1)% respectively in Ticagrelor group, and (63.6±3.8)% and(57.6±3.6)% respectively in Clopidogrel group, which showed that platelet aggregation inhibition effect was better in Ticagrelor than in Clopidogrel(t=14.40、17.20, both P=0.001). Two groups had no major life-threatening bleeding events.Bleeding incidence had no statistically significant difference between two groups(χ2=0.14, P=0.710), and the incidence of cardiovascular adverse events showed no statistically significant difference(χ2=0.04, P=0.840)between the 2 groups. Conclusions Preoperativeticagrelor loading treatment in emergency PCI therapy for acute ST segment elevation myocardial infarction shows stronger antiplatelet aggregation function, significantly improve postoperative TIMI flow, and does not increase the incidence of bleeding events. Key words: Myocardial infarction; Angioplasty, transluminal, percutaneous coronary

Quality of life improvement with rehabilitation according to constitution of the World Health Organization for coronary artery bypass graft surgery patients: A descriptive review.

This is a descriptive review focusing on trends of treatments required for postoperative coronary artery bypass graft surgery (CABG) patients to improve the quality of life (QOL).Methodology:The sources of literary research to understand the concepts of coronary artery disease according to Indian scriptures are Ayurveda texts, Bhagavad Gita, Patanjali Yoga Sutra. The data was typed in Sanskrit using Devanagari script and explanation in English was given. As per new research techniques, surgery, physiotherapy rehabilitation and Yoga are serving CABG patient's medical and psychological health better. The World Health Organization (WHO) defines health as physical, mental and social well-being later redefined with additional terms like environmental and spiritual health. This definition is similar to the Panchakosha concept in Yoga and Pancha Mahabhutas in Ayurveda. In cases of emergency or passive treatment, medication serves as a better option for physical health. In circumstances where the person is able to move in daily activities (just after discharge), rehabilitation serves as a better option for physical, mental and social health. Travel and reactions to climatic change serve environmental health. Last strategy, belief, cultural and traditional methods with scientific background serves as the spiritual health. These step-wise treatments are required for CABG patients to get the overall health or QOL. However, surgery and physiotherapy rehabilitation are advanced as per modern era which serves physical, mental, and social health also, but environmental health and spiritual health have yet to be addressed. As an ancient system of medicine, Yoga combines physical, mental, social, environmental and spiritual practices and it should be added as treatment along with surgery and physiotherapy rehabilitation. If all of these therapies were in the treatment protocol for CABG surgery patients, we would observe the changes of QOL and fulfill the requirements of constitution of the WHO. Integrating concepts of Yoga, Ayurveda, modern rehabilitation, surgery and patient cooperation with lifestyle change are the key to QOL improvements after CABG.

Safety of Continuous Infusion Ketorolac in Postoperative Coronary Artery Bypass Graft Surgery Patients.

Background:Continuous infusion ketorolac is sometimes utilized for analgesia in postoperative coronary artery bypass graft (CABG) patients despite contraindications for use. Limited literature surrounds this topic; therefore, this study was conducted to evaluate the safety of this practice. Methods: This retrospective cohort study evaluated the primary outcome of mortality and secondary outcomes of incidence of bleeding and myocardial infarction (MI). All patients who underwent isolated CABG surgeries and received continuous infusion ketorolac during the study period were included. An equal number of randomly selected isolated CABG patients served as control patients. Electronic medical records and the Society of Thoracic Surgeons (STS) database were utilized to determine baseline characteristics and outcomes; Results: One hundred and seventy-eight patients met inclusion; 89 in each group. More patients in the control group underwent on-pump surgeries (78.6% vs. 29.2%, p = 0.01) and had higher STS risk scores (1.1% vs. 0.6%, p = 0.003). There was no difference in mortality between the ketorolac group and control group (2.2% vs. 3.3%, p = 0.605). Additionally, no patients experienced a MI and there was no difference in bleeding incidence (5.5% vs. 6.7%, p = 0.58); Conclusions: No association was found between continuous infusion ketorolac and increased risk of mortality, MI, or bleeding events in postoperative CABG patients. Considerations to differences in baseline characteristics must be made when interpreting results.

Results of coronary artery spasm treatment after cardiac surgery procedures

Postoperative coronary artery spasm (CAS) is an infrequent life-threatening event after cardiac surgery. We have suggested to cross clamp aorta for short time and to inject nitrates into the aortic root in case of suspicion of CAS. It enable us to deliver nitrates especially into coronary arteries during operation (patent RU 2552890). Another method is conventional coronary angiography with injection of nitrates.

Stress echocardiography in paediatrics: implications for the evaluation of anomalous aortic origin of the coronary arteries.

Stress echocardiography in paediatrics is used to evaluate pre- and post-operative coronary artery conditions, as well as to gain haemodynamic information for a variety of diagnoses, although evidence regarding sensitivity, specificity, and predictive value is lacking. This review will consider the available literature with a focus on anomalous aortic origin of the coronary arteries and discuss a practical approach to test selection and use.

Postoperative diffuse coronary spasm after two valve surgery – A rare phenomenon

Postoperative coronary artery spasm is one of the grave complications of cardiac surgery and is usually seen in patients undergoing coronary artery bypass surgery. We describe the case of a 63 year old male patient developing postoperative spasm of the entire coronary tree after aortic & mitral valve replacement, manifesting as significant electrocardiographic changes. Urgent coronary angiography was performed which revealed diffuse spasm of the entire coronary tree. It resolved completely with intracoronary injection of Nitroglycerine. The present case highlights the likelihood of postoperative coronary spasm even after valve replacement surgery, and not just coronary bypass surgery. It also illustrated the usefulness of coronary angiography for both diagnosis and treatment of this entity.

Multiple daily doses of acetyl‐salicylic acid (ASA) overcome reduced platelet response to once‐daily ASA after coronary artery bypass graft surgery: a pilot randomized controlled trial

The efficacy of ASA for prevention of graft failure following CABG surgery may be limited by incomplete platelet inhibition due to increased post-operative platelet turnover. To determine whether acetyl-salicylic acid (ASA) 325mg once-daily or 81mg four-times daily overcomes the impaired response to ASA 81mg once-daily in post-operative coronary artery bypass graft (CABG) patients. We randomized 110 patients undergoing CABG surgery to either ASA 81mg once-daily, 81mg four times daily or 325mg once-daily and compared their effects on serum thromboxane B2 (TXB2 ) suppression and arachidonate-induced platelet aggregation. One hundred patients were included in the final analysis. Platelet counts fell after surgery, reached a nadir on day 2, and then gradually increased. Although there was near complete suppression of TXB2 on the second or third post-operative day, TXB2 levels increased in parallel with the rise in platelet count on subsequent days. This increase was most marked in patients receiving ASA 81mg once-daily and less evident in those receiving ASA four times daily. On post-operative day 4, (i) median TXB2 levels were lower with four times daily ASA than with either ASA 81mg once-daily (1.1ng/mL; Quartile(Q) Q1,Q3: 0.5, 2.4 and 13.3ng/mL; Q1,Q3: 7.8, 30.8ng/mL, respectively; P<0.0001) or ASA 325mg once-daily (3.4ng/mL; Q1,Q3: 2.0, 8.2ng/mL; P=0.002), and (ii) ASA given four times daily was more effective than ASA 81mg once-daily and 325mg once-daily at suppressing platelet aggregation. Four times daily ASA is more effective than ASA 81 and 325mg once-daily at suppressing serum TXB2 formation and platelet aggregation immediately following CABG surgery.

Spirometric values and chest pain intensity three days post-operative coronary artery bypass graft surgery

AimCoronary artery bypass graft surgery (CABG) is proved to have ventilatory complications and reduction in spirometric values. This study aimed to examine the hypothesis that reduction of post-operative chest pain intensity would be associated with improvement in the spirometric values for patient underwent CABG. Materials and method26 cardiac patients recruited for this study. Their convenience to the study inclusion criteria decided their eligibility. Through 3days after elective CABG their spirometric values were measured along with their perception to chest pain intensity using 0–10 numeric rating scale. Collected data were recorded and analyzed statistically. ResultsChest pain intensity showed progressive significant (P=0.0001) reduction through the 3days post-operative. On the other hand spirometric values also showed progressive improvement through the 3days post-operative. This improvement was significant for all measured spirometric values except for the ratio of forced expiratory volume in the 1st second to the forced vital capacity (P=0.134). There was no significant relationship between the chest pain intensity and spirometric values. This was applied to all measured spirometric values and to the 3days postoperative. ConclusionThe current study findings rejected the examined hypothesis that reduction of post-operative chest pain intensity would be associated with improvement in the spirometric values for patient underwent coronary artery bypass graft surgery. There was no significant relationship between the chest pain intensity and any of the spirometric values at any of the 3 post-operative days.

Alternative Physical Therapy Protocol Using a Cycle Ergometer During Hospital Rehabilitation of Coronary Artery Bypass Grafting: a Clinical Trial.

OBJECTIVETo compare the efficacy of a cycle ergometer-based exercise program to a standard protocol on the increment of the maximum distance walked during the six-minute walk test in the postoperative rehabilitation of patients submitted to coronary artery bypass grafting.METHODSA controlled clinical trial pilot, blinded to the outcome, enrolled subjects who underwent coronary artery bypass grafting in a hospital from Southern Brazil. Subjects were designated for the standard physical rehabilitation protocol or to an alternative cycle ergometer-based protocol through simple random sampling. The primary outcome was the difference in the maximum distance walked in the six-minute walk test before and after the allocated intervention.RESULTSTwenty-four patients were included in the analysis, 10 in the standard protocol and 14 in the alternative protocol group. There was an increment in the maximum distance walked in both groups, and borderline superiority in the intervention group comparing to the control group (312.2 vs. 249.7; P=0.06).CONCLUSIONThere was an increase in the maximum distance walked in the alternative protocol compared to the standard protocol. Thus, it is postulated that the use of a cycle ergometer can be included in physical rehabilitation in the hospital phase of postoperative coronary artery bypass grafting. However, randomized studies with larger sample size should be conducted to assess the significance of these findings.

Preoperative β-blockade in coronary artery bypass grafting surgery.

In the current issue, Brinkman and colleagues1 use the Society of Thoracic SurgeonsNationalDatabase (STS-ND) to study the effect of preoperative β-blockade on postoperative coronary artery bypass grafting (CABG) outcomes. Their results show no mortality advantage and a paradoxically increased incidence of atrial fibrillation (AF) in patients receiving preoperative β-blockers, findings that challenge the continuation of this practice and its use as a quality metric. I will examine the rationale for preoperative β-blockade, controversies regarding its use innoncardiac surgery, the valueof β-blockade in CABG, and reasonable clinical recommendations based on the preponderance of current evidence.

Post Hoc analysis of cardiopulmonary indicators trends among post-operative coronary artery bypass graft patients with normal ventilator weaning response and dysfunctional ventilator weaning response

Objectives: The objectives of this post hoc analysis was to describe the characteristics of cardiopulmonary indicators among patients with normal ventilator weaning response and dysfunctional ventilator weaning response after coronary artery bypass graft surgery, and to find the differences in characteristics of cardio pulmonary indicators between patients with normal ventilator weaning response and dysfunctional ventilator weaning response after coronary artery bypass graft surgery. Materials and Methods: A post hoc analysis was performed using available data. Descriptive and inferential statistics were used to describe and compare the data. Available data was collected using a retrospective chart audit of the patients who underwent coronary artery bypass graft surgery. All the statistical significance tests were performed as two-tailed tests. A p value of < 0.05 was considered significant. Results: The results revealed that there are significant differences between patients with normal ventilator weaning response and dysfunctional ventilator weaning response in the trends of cardiopulmonary indicators including respiratory rate, cardiac output, cardiac index, pulmonary artery diastolic pressure, and pulmonary artery systolic pressure during the first eight post-operative hours of coronary artery bypass graft surgery. Conclusions: Cardiopulmonary indicators may be used to assess the ventilator weaning process following coronary artery bypass graft surgery. The results may have implications to the assessment, planning, providing, evaluating, and coordinating post-operative care for patients undergoing coronary artery bypass graft surgery.

Factors associated to hypoxemia in patients undergoing coronary artery bypass grafting

Hypoxemia is a frequent pulmonary complication in the postoperative coronary artery bypass graft. Detection of factors associated with their occurrence may indicate patients at risk for this complication, which allows tracing specific therapeutic and consequently reduce morbidity and mortality. To identify related factors to hypoxemia occurrence in immediate coronary artery bypass graft postoperative. In this retrospective cohort study, we studied 100 patients submitted to elective om-pump artery bypass graft , between April 2010 and December 2011, at a reference university hospital for cardiac surgery in the state of Maranhão. It was considered hypoxemia gas exchange ratio less than or equal to 300 mmHg. Associated variables with perioperative hypoxemia were defined by the Student T test, G or Mann-Whitney tests, Chi-square, or Fisher's exact test and multiple linear regression. Among studied variables, high body mass index (P=0.036) and smoking (P=0.024) were significantly associated with hypoxemia in the immediate coronary artery bypass graft postoperative. Hypoxemia incidence in this period was 55% and did not affects mechanical ventilation duration and Intensive Care Unit lengh of stay. In this sample, body mass index and smoking were associated to hypoxemia. These data reinforce the importance of clinical assessment to identify patients at risk for this complication, considering its high incidence in immediate postoperative period.

Intraoperative Changes in Regional Wall Motion: Can Postoperative Coronary Artery Bypass Graft Failure Be Predicted?

To evaluate the accuracy of new intraoperative regional wall motions abnormalities (RWMAs) detected by transesophageal echocardiography (TEE) to predict early postoperative coronary artery graft failure. A retrospective study. A tertiary care university hospital. Five thousand nine hundred ninety-eight patients who underwent coronary artery bypass graft (CABG) surgery. An evaluation of RWMAs recorded with intraoperative TEE before and after cardiopulmonary bypass (CPB) in patients who had coronary angiography for suspected postoperative myocardial ischemia based on electrocardiogram (ECG), CK-MB, troponin T, hemodynamic compromise, low cardiac output, and malignant ventricular arrhythmia. Sensitivity, specificity, positive and negative predictive values, odds ratio, 95% confidence interval, and chi-square analysis were used. Thirty-nine patients (0.7%) underwent early coronary angiography for the suspicion of early graft dysfunction. Of the 32 patients with diagnosed early graft dysfunction, 5 patients (15.6%) had shown new intraoperative RWMAs as detected by TEE, 21 patients (65.6%) had no new RWMAs, no report was available in 5 patients (15.6%), and 1 examination (3.1%) was excluded because of poor imaging quality. The sensitivity of TEE to predict graft failure was 15.6%, the specificity was 57.1%, and the positive predictive and negative values were 62.5% and 12.9%, respectively. The odds ratio and 95% confidence interval was 0.1190 (0.0099-1.4257) when TEE was positive compared with coronary angiography. No association was found between new RWMAs detected with TEE and graft failure as documented with coronary angiography (p = 0.106). In this retrospective study, RWMAs detected with TEE were of limited value to predict early postoperative CABG failure.