[Is extensive usage of arterial grafts in revascularization of the circumflex appropriate?: comparative study with the saphenous vein].
From September 1975 to March 1992, 584 patients underwent coronary artery bypass grafting (CABG) including revascularization of the circumflex artery (LCX) with either saphenous vein (Group S, n = 496) or arterial grafts (Group A, n = 88). Group S was divided into two subgroups. Group S I is the patients who underwent CABG before April 1988, when the first case of arterial revascularization of the LCX, and Group S II is the patients who underwent CABG after April 1988. No significant differences were noted in early mortality, late mortality, or event free curve among three groups. Although graft flow was significantly less in Group A (27.8 +/- 12.8 ml/min) than Group S (60.0 +/- 35.7 ml/min), the patency rate was better in Group A (94.3%) than Group S I (88.6%) or Group S II (87.7%). The proportion of usage of arterial grafts in revascularization of the left anterior descending artery (LAD) was smaller in Group A (65.5%) than Group S II (80.3%), but the patency rate was acceptably good in both groups (Group A: 98.8%, Group S II: 99.5%). These findings justify extensive usage of arterial grafts to the LCX area under proper assignment of grafts to obtain good patency rate and long-term results with keeping quality of revascularization of the LAD area.
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
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Nishida
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Nemoto
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Koyanagi
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Endoh
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Koyanagi
D000009:Abdominal Muscles / Q000098:blood supply; D000368:Aged; D001158:Arteries / Q000637:transplantation; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013895:Thoracic Arteries / Q000637:transplantation*; D014654:Vascular Patency