Differences in adaptation to growth of children between internal thoracic artery and saphenous vein coronary bypass grafts.
BACKGROUND
It is not known how the internal thoracic artery (ITA) and saphenous vein graft (SVG) adapts to somatic growth of pediatric patients who underwent coronary artery bypass grafting (CABG).


METHODS
Twenty-two ITAs and 6 SVGs in 17 patients who underwent at least three postoperative catheterizations with biplanar cineangiography and followed for a minimum of 5 years were evaluated. We evaluated the length, diameter and curvature of the grafts by cineangiographies which were performed at 1 month, 1 year, 5 years and more than 5 years postoperatively.


RESULTS
The length of the ITA (1-month: 117+/-31 mm, 1-year: 134+/-32 mm, 5-years: 146+/-28 mm, and >5-years: 155+/-34 mm, p=0.032) and diameter of the ITA (1.4+/-0.4 mm, 2.0+/-0.7 mm, 2.3+/-0.6 mm and 2.6+/-0.6 mm, p<0.0001) significantly increased over time, but neither the length nor diameter of the SVG length: 121+/-33 mm, 119+/-29 mm, 119+/-25 mm and 126+/-1 mm, p=0.9907; diameter: 4.1+/-1.0 mm, 3.9+/-0.7 mm, 4.0+/-0.8 mm and 3.3+/-0.4 mm, p=0.5784) increased. Although the ITA exhibited no change in curvature over time (1 month: 1.15+/-0.07, late: 1.15+/-0.07, p=0.8490), the curvature of the SVG significantly decreased over time (1 month: 1.42+/-0.19 and late: 1.25+/-0.16, p=0.0277). The percent segmental length of ITAs were changed little from early to late after CABG (1 month: proximal: 33.7+/-7.0%, middle: 33.3+/-7.9% and distal: 32.9+/-7.9%, vs late: 34.3+/-7.2%, 33.2+/-7.9% and 32.5+/-7.9%, p=0.937).


CONCLUSIONS
ITAs grow in proportion to somatic growth, while SVGs course in a more linear fashion in adapting to patient growth.
Kameda
Y
Y
Department of Surgery III, Nara Medical University, Kashihara, Nara, Japan. ykameda@naramed-u.ac.jp
Kitamura
S
S
Taniguchi
S
S
Kawata
T
T
Mizuguchi
K
K
Nishioka
H
H
Sakaguchi
H
H
D000222:Adaptation, Physiological; D000293:Adolescent; D001830:Body Surface Area; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000637:transplantation*; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000637:transplantation*