Long-term follow-up of patients undergone coronary artery bypass grafting with exclusive use of arterial grafts.
OBJECTIVE
To evaluate the long-term results of the coronary artery bypass grafting with exclusive use of arterial grafts for patients with triple vessel disease.


METHODS
We evaluated 136 patients who underwent isolated coronary artery bypass grafting between January 1995 and December 1997. 353 grafts were used for revascularization of 449 arteries (mean: 3.30 per patient). Grafts used were left internal thoracic artery (99.2%), right internal thoracic artery (56.6%), radial artery (87.5%), right gastroepiploic artery (20.5%) and one inferior epigastric artery. 76 (55.8%) patients received composite grafts ('Y' shape) and 66 (48.5%) patients received sequential anastomoses.


RESULTS
Hospital mortality was 4.4%. In the long-term follow-up (9.5 to 12.8 years), 82.1% of the patients were free of cardiac events. 20 (17.9%) patients had hospital readmission due to cardiac events: 15 presented angina and five presented acute myocardial infarction, and three of them presented associated heart failure. Eighth (7.1%) patients needed coronary reintervention: one of them underwent coronary bypass reoperation and the others underwent coronary angioplasty with stent. Estimated probability of cardiac event-free was 98.2%, 95.4% e 84.2% at 1, 5 and 10 years follow-up respectively. There were 16 (14.2%) late deaths and four of them (3.6%) were cardiac-related. Actuarial 12.8-year-survival of all deaths was 85% in this group.


CONCLUSIONS
Coronary artery bypass grafting with exclusive use of arterial grafts is a safe procedure for patients with triple vessel coronary disease with good long-term results.
Abdouni
Ahmad Ali
AA
Heart Institute of Hospital das Clínicas of the Medicine School, University of São Paulo. dr.ahmad@ig.com.br
Lisboa
Luiz Augusto Ferreira
LA
Puig
Luiz Boro
LB
Tossuniam
Carlos Eduardo
CE
Dallan
Luís Alberto Oliveira
LA
Jatene
Fabio Biscegli
FB
Oliveira
Sergio Almeida de
SA
Stolf
Noedir Antonio Groppo
NA
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D024405:Gastroepiploic Artery / Q000637:transplantation*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D017534:Radial Artery / Q000637:transplantation*; D012086:Reoperation / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome