[Coronary artery bypass surgery in patients with familial hypercholesterolemia].
Coronary artery bypass grafting (CABG) was performed in 48 patients with heterozygous familial hypercholesterolemia (FH). Seventy-nine percent of these patients had three-vessel disease or left main trunk disease. The internal thoracic artery was used for grafting in 26 patients and the right gastroepiploic artery was used in 4 patients. Although no patient died during surgery, one died subsequently from graft-versus-host disease. Graft patency at one month after CABG was 95% in vein grafts, 100% in arterial grafts, and 97% overall. Histological study revealed that arterial grafts in patients with FH had similar structures to those in non-FH patients, without evidence of atherosclerosis. All patients were prescribed anti-cholesterol drugs to control serum cholesterol levels, and 4 patients underwent LDL-apheresis because of poor control. Survival rate at 11 years after CABG was 83% without cardiac death. Cardiac event-free rate in 47 surviving patients was 53% at 10 years after CABG in vein bypass group, 93% at 5 years in the arterial graft group, and 58% at 10 years overall. Results of CABG were as good in FH as in non-FH patients, using arterial grafts and anticholesterol therapy.
Tedoriya
T
T
Department of Surgery (1), Kanazawa University School of Medicine, Japan.
Kawasuji
M
M
Sakakibara
N
N
Ueyama
K
K
Takemura
H
H
Watanabe
Y
Y
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013895:Thoracic Arteries / Q000637:transplantation
D000924:Anticholesteremic Agents