Effect of coronary artery bypass grafting on native coronary artery stenosis. Comparison of internal thoracic artery and saphenous vein grafts.
BACKGROUND
The purpose of this study was to investigate the influence of coronary artery bypass grafting on the degree of stenosis of the native coronary artery.


METHODS



METHODS
retrospective data analysis.


METHODS
University hospital.


METHODS
consecutive patients undergoing coronary artery bypass grafting (n=52). Bypasses using internal thoracic artery grafts (n=26) and saphenous vein grafts (n=37) to incompletely occluded coronary arteries were studied.


METHODS
coronary artery bypass grafting using internal thoracic artery or saphenous vein grafts.


METHODS
stenosis of the native coronary artery on angiography.


RESULTS
Three recipient coronary arteries bypassed with internal thoracic artery grafts (12%) and 14 recipient coronary arteries bypassed with saphenous vein grafts (38%) showed progression of narrowing (p=0.024). Two recipient coronary arteries bypassed with internal thoracic artery grafts (8%) and 13 recipient coronary arteries bypassed with saphenous vein grafts (35%) showed total occlusion (p=0.016). Hypertension, hyperlipidemia, diabetes mellitus, and smoking history did not correlate with progression of stenosis of the native coronary arteries. Graft flow measured during surgery in the saphenous vein grafts was not significantly different between the group that exhibited progression of the native stenosis and the group that did not.


CONCLUSIONS
Coronary artery bypass grafting with saphenous vein grafts may result in progression of stenosis of the recipient coronary artery. This is less likely after coronary artery bypass grafting with internal thoracic artery grafts. This difference may be due to the ability of the pedicled internal thoracic artery graft to regulate flow. Thus competitive flow in the native coronary artery is minimized. This has significant clinical implications.
Hamada
Y
Y
Department of Surgery II, Ehime University School of Medicine, Sigenobu, Ehime, Japan.
Kawachi
K
K
Yamamoto
T
T
Nakata
T
T
Kashu
Y
Y
Watanabe
Y
Y
Sato
M
M
D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors