Patency of cryopreserved saphenous vein grafts as conduits for coronary artery bypass surgery.
OBJECTIVE
To determine the angiographic patency of cryopreserved saphenous vein grafts used as conduits during coronary artery bypass surgery and whether this is affected by postoperative immunosuppressive therapy.


METHODS
A retrospective review of medical records and coronary angiograms of patients at a university hospital.


METHODS
Eleven patients undergoing 12 coronary artery bypass operations during which a total of 26 distal coronary anastomoses were created using cryopreserved vein grafts.


METHODS
Eight postoperative coronary angiograms were performed in 10 patients surviving longer than 1 week. All angiograms were performed on the basis of symptoms of suspected myocardial ischemia. Angiographic results, postoperative anticoagulation, and therapy with immunosuppressive agents were analyzed.


RESULTS
Seventeen cryopreserved vein grafts were studied; one (6%) was patent, 12 (71%) were occluded, and 4 (23%) were stenosed. In patients treated with azathioprine, seven of the eight cryopreserved vein grafts were occluded. In patients not receiving immunosuppression, five were occluded, three were stenosed, and one was patent. All internal mammary grafts were widely patent.


CONCLUSIONS
Cryopreserved vein grafts have a poor angiographic patency which did not appear to be affected by immunosuppressive therapy with azathioprine. The use of this graft should be restricted and alternative arterial conduits utilized.
Iaffaldano
R A
RA
Loyola University Medical Center, Department of Cardiology, Maywood, Ill. 60153, USA.
Lewis
B E
BE
Johnson
S A
SA
Piffare
R
R
McKiernan
T L
TL
D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D011182:Postoperative Care; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000502:physiology / Q000637:transplantation; D013997:Time Factors; D014654:Vascular Patency / Q000187:drug effects / Q000502:physiology
D007166:Immunosuppressive Agents; D001379:Azathioprine