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KMID : 0364020090420030324
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Korean Journal of Thoracic and Cardiovascular Surgery
2009 Volume.42 No. 3 p.324 ~ p.330
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Saphenous Vein Graft as a Composite Graft in Patients Who Are Undergoing Off-pump Coronary Artery Bypass: The Early Results
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Hwang Ho-Young
Kim Jun-Sung
Choi Eun-Seok
Lee Jae-Hang
Kim Ki-Bong
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Abstract
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Background: The long term patency of the free saphenous vein graft, which is the most commonly used conduit, anastomosed to the ascending aorta has been reported to be lower than that of arterial grafts. We evaluated the early clinical outcome and the angiographic patency of the saphenous vein composite graft based on the left internal thoracic artery, and compared these results with those of using arterial composite grafts.
Material and Method: From September 2006 to October 2008, 419 patients underwent off-pump coronary revascularization. Among those, 295 patients (70.4%) were revascularized using composite grafts (group I: saphenous vein composite graft, n=71, group II: arterial composite graft, n=224). The clinical results were compared between the 2 groups. Early postoperative coronary angiograms were performed in all the patients. (1.6±1.6 days)
Result: The number of the distal anastomosis per patient was 3.5±1.0 and 3.1±0.8 in group I and II, respectively (p=.002). The operative mortality (n=2, 0.7%) and postoperative complications such as atrial fibrillation (n=73, 24.7%), perioperative myocardial infarct (n=6, 2.0%), acute renal failure (n=6, 2.0%), reoperation for bleeding (n=5, 1.7%), cerebrovascular accident (n=3, 1.0%), and mediastinitis (n=1, 0.3%) were not related with the use of saphenous vein graft. Early coronary angiograms revealed a 96.9% (126/130) for the saphenous vein grafts and a 98.8% (479/485) for the composite graft in group II (p=.231).
Conclusion: Our data suggested that a saphenous vein graft might be used as an alternative conduit to the arterial graft for constructing a composite graft, as based on our early clinical and angiographic results. Further study is required to establish the long-term efficacy of using a saphenous vein as a composite graft.
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KEYWORD
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Saphenous vein, Coronary artery bypass, Graft patency
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