Midterm angiographic follow-up after off-pump coronary artery bypass: serial comparison using early, 1-year, and 5-year postoperative angiograms.
OBJECTIVE
We analyzed the angiographic changes of the anastomotic sites at three time points for 5 years after off-pump coronary artery bypass surgery.


METHODS
Of the 402 patients who underwent off-pump coronary artery bypass surgery between January 1998 and December 2001, 240 patients who received the early, 1-year, and 5-year follow-up coronary angiograms regardless of the patient's anginal symptoms were studied. Morphologic changes of grafts were traced by the FitzGibbon grading system.


RESULTS
Overall graft patency rates (FitzGibbon grade A+B) at early, 1-year, and 5-year angiography were 98.6%, 91.9%, and 88.3%, respectively. Graft patency rates in the left anterior descending artery, left circumflex artery, and right coronary artery territories were similar at early angiograms (P = .162). However, graft patency rate in the left anterior descending artery territory was higher than that in the left circumflex artery and right coronary artery territories at both the 1-year (P < .001) and 5-year (P < .001) angiograms. Of the 31 FitzGibbon grade B arterial grafts (internal thoracic artery and right gastroepiploic artery) at early angiography, 10 became occluded and 19 became grade A at 5-year angiography. In the saphenous vein grafts, grade B lesions gradually increased during the 5 postoperative years (2.6% vs 6.5% vs 13.3%).


CONCLUSIONS
Midterm angiographic follow-up demonstrated acceptable patency rates of grafts after off-pump coronary artery bypass surgery. Approximately half of the FitzGibbon grade B arterial grafts in the early angiograms became grade A at 5 years after surgery, but the proportion of grade B saphenous vein grafts gradually increased over the 5 postoperative years.
Kim
Ki-Bong
KB
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. kimkb@snu.ac.kr <kimkb@snu.ac.kr>
Cho
Kwang Ree
KR
Jeong
Dong Seop
DS
D000368:Aged; D000704:Analysis of Variance; D017023:Coronary Angiography / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality; D011336:Probability; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014654:Vascular Patency