Significance of new Q waves after bypass grafting: correlations between graft patency, ventriculogram, and surgical venting technique.

Abstract:

:New postoperative electrocardiographic Q waves have been described in eight of 40 per cent of patients undergoing bypass grafting for coronary artery disease. Various theories have been proposed to explain these new Q waves. Correlations of new Q waves to vein bypass occlusion, prolonged pump time or aortic cross-clamping time are controversial. Indeed, whether or not the appearance of new postoperative Q waves means real transmural myocardial infarction is not clear. We report herein our experience with postoperative Q waves in 56 patients with vein bypass grafts and the relationship of new Q waves to ventricular venting, graft patency, and the postoperative ventriculogram. Our observations indicate that: (1) Not all Q waves are due to occlusion of the saphenous bypass grafts (as noted by others). (2) A certain percentage of new Q waves may not reflect true transmural myocardial infarction, especially when all the vein grafts are patent and the postoperative ventriculograms show improvement. (3) Some new Q waves reflect true transmural infarction due to occlusion of grafts or of distal coronary arteries with deteriorated left ventriculograms. (4) The high incidence of new Q waves in patients with ventricular vents is probably due to direct myocardial trauma at the apex of the left ventricle.

journal_name

Am Heart J

journal_title

American heart journal

authors

Aintablian A,Hamby RI,Hoffman I,Weisz D,Voleti C,Wisoff BG

doi

10.1016/0002-8703(78)90233-8

subject

Has Abstract

pub_date

1978-04-01 00:00:00

pages

429-40

issue

4

eissn

0002-8703

issn

1097-6744

pii

0002-8703(78)90233-8

journal_volume

95

pub_type

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