title: Accelerated graft disease in a composite saphenous vein with internal thoracic artery in a chronic renal dialysis patient.
abstract: A 59-year-old man with 18-year history of renal dialysis due to chronic nephritis suffered coronary artery disease, which was complete occlusion of the right coronary artery and diffuse 90% stenosis of the proximal left anterior descending artery. Off-pump coronary artery bypass grafting was performed. Saphenous vein (SV) was anastomosed with left internal thoracic artery (ITA) as a T-graft. Left ITA was anastomosed to the left anterior descending artery. The end of SV was sewn on the posterior descending artery. Coronary and graft angiography performed 2 weeks after the operation showed good patency with good distal run-off of both left ITA and SV. Three months after the operation, he was admitted with unstable angina. Angiography revealed accelerated SV graft stenosis without any change of prior coronary disease. However, angiography 7 months after the operation revealed complete obstruction of the SV graft when he was admitted because of recurrent anginal pain.
authors.affiliation: Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Satsuki
authors.initials: S
authors.lastname: Fukushima
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Niwaya
authors.forename: Osamu
authors.initials: O
authors.lastname: Tagusari
authors.forename: Ko
authors.initials: K
authors.lastname: Bando
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakajima
mesh_terms: D000787:Angina Pectoris / Q000209:etiology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D012008:Recurrence; D006435:Renal Dialysis / Q000009:adverse effects*; D012501:Saphenous Vein / Q000637:transplantation*