Serial angiographic follow-up of grafts one year and five years after coronary artery bypass surgery. 2006

Kwang Ree Cho, and Jun-Sung Kim, and Jae-Sung Choi, and Ki-Bong Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 28 Yeon-Gun Dong, Jong-Ro Gu, Seoul 110-744, South Korea.

OBJECTIVE We studied retrospectively the patency of grafts after coronary artery bypass grafting (CABG) using serial angiographies performed one year and five years after surgery. METHODS One hundred and nine patients who had available coronary angiographies at both one year and five years after CABG were included. Morphologic changes of anastomotic sites and grafts were traced in the same group of patients using the FitzGibbon grading system. RESULTS The arterial graft patency rate (FitzGibbon grade A+B) was significantly higher than the saphenous vein grafts at both one year (98.0% vs 82.4%, p<0.001) and five years (90.7% vs 80.2%, p=0.006) after surgery, respectively. The arterial graft patency rate was superior to vein grafts in the left anterior descending coronary artery territory at both one year (97.5% vs 82.0%, p=0.001) and five years (90.9% vs 78.0%, p=0.042) postoperatively. Other territories showed similar patency rates between arterial and vein grafts. The vein graft patency rate at five years postoperatively was lowest in the right coronary territory when compared with other territories. When the patency pattern was compared between postoperative years 1 and 5, the proportion of FitzGibbon grade B grafts increased significantly in the vein grafts (3.1% vs 7.5%, p=0.002), while that of arterial grafts remained stable (8.6% vs 7.3%, p=0.774). When the graft patency at postoperative year 5 was compared between patients with recurrent angina and those without, the patients with recurrent angina showed a higher proportion of FitzGibbon grade B grafts (19.2% vs 4.8% in arterial grafts, p=0.023; 20.5% vs 4.8% in vein grafts, p=0.003) and lower grade A grafts (65.4% vs 86.4% in arterial grafts, p=0.019; 43.6% vs 78.2% in vein grafts, p<0.001), and a lower vein graft patency rate (64.1% vs 83.0%, p=0.014). CONCLUSIONS The arterial graft patency rate was significantly higher than that of saphenous vein grafts, especially in the left anterior descending coronary artery territory, at one year and five years postoperatively. The decreased patency rate of the vein grafts, along with insulin-dependent diabetes mellitus, were associated with angina recurrence.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004812 Epidemiologic Methods Research techniques that focus on study designs and data gathering methods in human and animal populations. Epidemiologic Method,Epidemiological Methods,Methods, Epidemiologic,Epidemiological Method,Method, Epidemiologic,Method, Epidemiological,Methods, Epidemiological
D005260 Female Females
D006083 Graft Occlusion, Vascular Obstruction of flow in biological or prosthetic vascular grafts. Graft Restenosis, Vascular,Vascular Graft Occlusion,Vascular Graft Restenosis,Graft Restenoses, Vascular,Occlusion, Vascular Graft,Restenosis, Vascular Graft
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000787 Angina Pectoris The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION. Angor Pectoris,Stenocardia,Stenocardias
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D012501 Saphenous Vein The vein which drains the foot and leg. Saphenous Veins,Vein, Saphenous,Veins, Saphenous

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