title: Composite lengthened arterial conduits: long-term angiographic results of an uncommon surgical strategy.
abstract: BACKGROUND
  We sought to evaluate the long-term patency rate of composite lengthened conduits.
  
  
  RESULTS
  From December 1991 to April 2000, 43 patients had a composite lengthened arterial conduit. There was a mean of 2.83 +/- 1.23 anastomoses per patient. No 30-day mortality occurred. Five patients died from 3 to 84 months after the operation (mean, 38.6 +/- 34.6 months). After a mean follow-up of 57.0 +/- 32.3 months (range, 3-99 months), all the survivors are asymptomatic. The only cardiac major events recorded were 2 (4.6%) late acute myocardial infarctions in the patients who died. Eight-year survival and event-free survival were both 80.4% +/- 9.1% (range, 3%-93%). In the early period (13.5 +/- 4.8 days) in 26 patients, 26 arterial composite lengthened conduits and 37 distal anastomoses had postoperative angiographic control; all the anastomoses were rates as grade A, according to Fitzgibbon classification. In the late period (29 +/- 30 months) in 23 patients, 23 arterial composite lengthened conduits and 34 distal anastomoses were checked; the patency rate was 22 (95.6%) of 23 for the composite lengthened conduits and 33 (97%) of 34 for the distal anastomoses.
  
  
  CONCLUSIONS
  In particular situations, when the length of an arterial conduit is not enough to allow a correct use of the graft, lengthening of an arterial conduit can be a safe and effective technique.
authors.affiliation: Department of Cardiac Surgery, G. D'Annunzio University, Chieti, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vitolla
authors.forename: G
authors.initials: G
authors.lastname: Di Giammarco
authors.forename: G
authors.initials: G
authors.lastname: Teodori
authors.forename: V
authors.initials: V
authors.lastname: Mazzei
authors.forename: C
authors.initials: C
authors.lastname: Canosa
authors.forename: M
authors.initials: M
authors.lastname: Di Mauro
authors.forename: S
authors.initials: S
authors.lastname: D'Alessandro
authors.forename: A M
authors.initials: AM
authors.lastname: Calafiore
mesh_terms: D000714:Anastomosis, Surgical; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods