title: Comparison of perfusion and thickening between vein and right internal thoracic artery composite grafts from a randomized trial substudy.
abstract: BACKGROUND
  Improvements in myocardial perfusion and thickening were compared in coronary artery bypass grafting patients who received saphenous vein (SV) Y-composite grafts versus those who received right internal thoracic artery ([R]ITA) Y-composite grafts.
  
  
  METHODS
  Of the 224 patients enrolled in a randomized clinical trial, 116 patients (SV group, n = 65; RITA group, n = 51) in whom myocardial single-photon-emission computed tomography was performed preoperatively, and at 3 months and 1 year postoperatively, were retrospectively studied. A 20-segment model was adopted, and a total of 792 ischemic myocardial segments (SV group, n = 443; RITA group, n = 349) were analyzed. The reversibility score (rest minus stress perfusion value) as an indicator of ischemic myocardium, and Z-values for segmental myocardial thickening, were calculated.
  
  
  RESULTS
  Compared with preoperative values, both myocardial perfusion and segmental myocardial thickening had improved significantly at 3 months and 1 year postoperatively (reversibility scores [mean ± SD] were, respectively: 13.5 ± 8.0 vs 5.8 ± 6.2 and 5.1 ± 6.2, P < .001; Z-values were -1.13 ± 1.53 vs -0.62 ± 1.40 and -0.67 ± 1.35, P < .001). Mixed-effect model analyses showed no differences in improvements in myocardial perfusion and segmental myocardial thickening between the 2 groups 1 year after revascularization. Separate analysis demonstrated less improvement of myocardial perfusion in the right coronary artery territory of the RITA group than the SV group, with marginal significance (P = .056).
  
  
  CONCLUSIONS
  Improvements in myocardial perfusion and segmental myocardial thickening were similar between the 2 groups at 1 year after revascularization. The SV, versus the right ITA, composite graft may be more beneficial in perfusion improvement of the right coronary artery territory.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Chul
authors.initials: JC
authors.lastname: Paeng
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hong Chul
authors.initials: HC
authors.lastname: Oh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Han
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kimkb@snu.ac.kr.
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
keywords: myocardial SPECT; off-pump CABG; saphenous vein