[Evaluation of the proximal stenosis of native coronary vessels after coronary artery bypass grafting].
This study was designed to evaluate proximal native coronary stenosis (PNCS) after coronary artery bypass grafting (CABG). In 36 patients undergoing postoperative coronary arteriography, the PNCS bypassed with internal thoracic artery (ITA), saphenous vein graft (SVG) and right gastroepiploic artery (RGEA) progressed in 9 of 23 vessels (39%), in 15 of 28 vessels (53%), in 4 of 11 vessels (36%), respectively. Stenosis of no grafted coronary vessels progressed in 3 of 26 vessels (11%). Twelve native coronary vessels (9: 99% and 3: 90% stenosis vessels) bypassed with grafts were obstructed. This study confirms that the PNCS progresses significantly by CABG just after the operation and that it tends to progress highly with SVG in comparison with arterial grafts such as ITA or RGEA. Because operative mortality for repeated CABG is approximately twice as high as that for primary CABG, it is important to decide whether early postoperative percutaneous transluminal angioplasty is needed or not, in considering of future graft failure and stenosis progression of the native coronary vessels by CABG.
Hirai
S
S
Department of Thoracic and Cardiovascular Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Hamanaka
Y
Y
Mitsui
N
N
Morifuji
K
K
Sutoh
M
M
D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology; D024405:Gastroepiploic Artery / Q000637:transplantation; D006801:Humans; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation; D014654:Vascular Patency