Our Summary

This study looked at the difference in outcomes and costs for patients who have had coronary artery bypass surgery (a procedure that improves blood flow to the heart) and are then tested using two different techniques: Coronary Computed Tomography Angiography (CCTA) or Single Photon Emission Tomography (SPECT). The results showed that more patients ended up needing further tests if they were initially tested with CCTA compared to SPECT. Moreover, these extra tests were twice as expensive for the CCTA group compared to the SPECT group. However, the overall costs, which included the initial test costs, were lower in the CCTA group. Despite these findings, the researchers suggest that SPECT may remain the preferred first test until CCTA can show it provides better risk predictions for these patients.

FAQs

  1. What were the two testing techniques compared in the study after coronary artery bypass surgery?
  2. Did the study find that more patients needed further tests with the Coronary Computed Tomography Angiography (CCTA) or Single Photon Emission Tomography (SPECT)?
  3. Despite the higher cost of additional tests for the CCTA group, why were the overall costs lower compared to the SPECT group?

Doctor’s Tip

A helpful tip a doctor might tell a patient about CABG is to discuss with your healthcare provider which diagnostic test is most appropriate for you, such as CCTA or SPECT, to ensure the best outcome and cost-effective care. It is important to have open communication with your healthcare team to make informed decisions about your treatment plan.

Suitable For

Patients who are typically recommended for coronary artery bypass grafting (CABG) include those with severe coronary artery disease, blockages in multiple coronary arteries, left main coronary artery disease, or those who have not responded well to other treatments such as medication or lifestyle changes. Additionally, patients with significant symptoms such as chest pain, shortness of breath, or decreased exercise tolerance may also be recommended for CABG. Ultimately, the decision to undergo CABG is made on a case-by-case basis by a healthcare provider after considering the patient’s individual medical history, symptoms, and risk factors.

Timeline

  • Before CABG:
  1. Patient experiences symptoms of coronary artery disease such as chest pain or shortness of breath.
  2. Patient undergoes diagnostic tests such as stress tests, echocardiograms, and coronary angiography to determine the extent of blockages in the coronary arteries.
  3. Based on the results of these tests, a decision is made to proceed with CABG surgery.
  • After CABG:
  1. Patient undergoes the CABG surgery, during which a bypass graft is created to reroute blood flow around the blocked coronary artery.
  2. Patient is monitored closely in the intensive care unit immediately after surgery.
  3. Patient is gradually transitioned to a regular hospital room as they recover.
  4. Patient undergoes cardiac rehabilitation to help improve heart function and physical strength.
  5. Patient is discharged from the hospital and continues to follow up with their healthcare provider for monitoring and management of their heart health.

What to Ask Your Doctor

  1. What is the purpose of having a coronary artery bypass surgery (CABG)?
  2. How will the outcomes of the surgery be monitored and evaluated?
  3. What are the potential risks and complications associated with CABG?
  4. How long is the recovery process expected to take?
  5. What lifestyle changes or medications will be necessary post-surgery?
  6. What is the difference between Coronary Computed Tomography Angiography (CCTA) and Single Photon Emission Tomography (SPECT) in terms of testing for post-surgery outcomes?
  7. Why might one technique be preferred over the other for post-surgery testing?
  8. What are the advantages and disadvantages of using CCTA versus SPECT for monitoring post-surgery outcomes?
  9. How will the results of the chosen test affect future treatment plans?
  10. Are there any additional costs associated with using one testing technique over the other for post-surgery monitoring?

Reference

Authors: Small GR, Erthal F, Alenazy A, Yam Y, Edwards M, Crean A, Beanlands RS, Ruddy TD, Chow BJW. Journal: Int J Cardiol Heart Vasc. 2020 Mar 5;27:100494. doi: 10.1016/j.ijcha.2020.100494. eCollection 2020 Apr. PMID: 32181322