CABG late angiographic grafting patency analysis in patients with recurrent symptoms.
OBJECTIVE
Left internal thoracic artery (LITA) grafting has become the gold standard in coronary artery bypass graft procedure (CABG). In order to optimize the use of LITA or other grats, sequential anastomosis has been used. There is no consensus on equivalence of results between isolated and sequential grafts. The aim of this study is to compare the patency of isolated versus sequential grafts.


METHODS
From January 2000 to August 2007, a retrospective patency analysis of the grafts used in 88 symptomatic patients who underwent CABG procedure in our Service was performed through cinecoronariography. Statistical analysis was performed through Student's t test. Each distal anastomosis was considered an independent graft.


RESULTS
The mean postoperative period was of 53 +/- 138 months and mean age was 64 +/- 11 years. LITA isolated grafts presented patency rate significantly higher than the sequential grafts, respectively 92% (46/50) and 77% (30/39) P = 0.02. However, in injured coronary arteries of >or= 70%, isolated LITA patency rate was similar to sequential grafts, (95%; 37/39) and (93%; 26/28) respectively; P = 0.37. Mean radial artery patency rate was similar to isolated 71% (5/7) and sequential 90% (19/21) grafts; P = 0.10. Saphenous vein patency rates were similar for isolated 72% (31/43) and sequential 81% (73/90) grafts; P = 0.12. There was no difference between radial artery and saphenous vein patency rates.


CONCLUSIONS
In symptomatic patients, isolated LITA patency is superior than sequential LITA. However, in coronary injuries of >or= 70%, the isolated and sequential patency rates are similar. Sequential grafts from radial artery and saphenous vein are similar to their respective isolated grafts.
Silva
Roberto Rocha E
RR
Hospital Paulo Sacramento. rors@terra.com.br
Truffa
Márcio Augusto
MA
Birolli
José Ricardo Bueno de Moraes
JR
Silva
Tárcio Figueiredo
TF
De Mola
Ricardo
R
Oliveira
João Bosco de
JB
D000714:Anastomosis, Surgical / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008323:Mammary Arteries / Q000000981:diagnostic imaging* / Q000637:transplantation; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging* / Q000637:transplantation; D011859:Radiography; D012008:Recurrence; D012016:Reference Values; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000637:transplantation; D014654:Vascular Patency / Q000502:physiology*