A medical team at the University of Galway has developed a way to conduct less invasive heart bypass surgery that is set to improve patient care and lead to substantial savings in healthcare costs.
In a clinical trial procedure, they used high-resolution CT-scan imagery to pinpoint coronary artery disease and blockages, avoiding the need for invasive angiography — which punctures a blood vessel to insert a wire, cable or catheter while using a dye for X-ray monitoring.
The academics and surgeons involved, including specialists in Europe and the US, said their approach shows the combination of “non-invasive cardiac-CT, with AI-powered blood flow scanning, is safe and feasible, and a potential game-changer for planning coronary artery bypass grafting”.
Images from the scans used during the clinical trial were analysed by the research team, who liaised with surgeons in cardiac hospitals in Europe and the US through telemedicine. The study was overseen by the university’s Corrib Research Centre for Advanced Imaging and Core Lab. The findings were published on Sunday in the European Heart Journal.
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This first in-human study had 99.1 per cent feasibility “which means heart bypass surgery without undergoing invasive diagnostic catheterisation is feasible and safe, driven by the good diagnostic accuracy of the cardiac CT scan and AI-powered blood flow analysis”.
In terms of safety and effectiveness, it had similar outcomes to patients who underwent conventional invasive angiogram investigations. The team noted safety issues inherent to invasive investigations were mitigated by their non-invasive technique.
Trial chairman prof Patrick W Serruys of the University of Galway said: “The results have the potential to simplify the planning for patients undergoing heart bypass surgery. [This] puts University of Galway on the frontline of cardiovascular diagnosis, planning and treatment of coronary artery disease.”
The study was carried out in cardiac hospitals in Europe and the US and involved 114 patients who had severe blockages in multiple vessels, limiting blood flow to their hearts. The cardiac CT used has a special resolution making the non-invasive images as good or even better than images traditionally obtained by a direct injection of contrast dye in the artery of the heart through a catheter.
“The potential for surgeons to address even the most intricate cases of coronary artery disease using only a non-invasive CT scan, and FFRCT represents a monumental shift in healthcare,” said Prof Serruys.
“This approach not only alleviates the diagnostic burden in cath labs but also paves the way for transforming them into dedicated ‘interventional suites’ — ultimately enhancing patient workflows.”
A cath lab is a specially designed theatre where tests and procedures on the heart and circulatory system take place. Patients usually are awake during procedures as these tend to be minimally invasive and require only local anaesthetic.
Dr Yoshi Onuma, medical director of Corrib Research Centre, said: “Exploring the potential for minimising diagnostic catheterisation procedures is important for several reasons — a catheterisation procedure is invasive and it is unpleasant for the patient. It is also costly for the health service. While there is a minimal risk associated with the procedure, it is not entirely risk-free.”
Their approach “may become a game-changer, altering the traditional relationship between GP, radiologist, cardiologist and cardiothoracic surgeon for the benefit of the patient”, he said.
The researchers plan to conduct a large-scale randomised trial involving more than 2,500 patients from 80 hospitals across Europe.
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