Effect of Proximal Anastomotic Diameter on Venous Bypass Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting.
BACKGROUND
In this study, the relationship between patency of saphenous vein (SV) graft and different sizes of aorta wall punches was investigated during the follow-up period after coronary artery bypass graft surgery. We also evaluated the other possible factors affecting SV graft patency.


METHODS
This study consisted of 266 consecutive and symptomatic patients with postoperative angiography. The primary endpoint was at least one saphenous graft failure observed from coronary computed tomography angiography (cCTA) and/or invasive angiography after surgery. Groups were created as SV occluded and patent group. Survival curves of patients in groups were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the Cox proportional hazard model.


RESULTS
Cox-regression analysis demonstrated influence of older age (P = .023) and Diabetes Mellitus (DM) (P = .002) on SV graft failure. However, increasing ejection fraction (P = .011) was a protective factor against SV graft failure. There was no significant difference between the two groups in terms of usage rate of the punches with different diameters (P = .296).


CONCLUSIONS
The incidence of SV graft patency does not seem to increase in patients whose 4.8-mm aortic punch was used during proximal anastomosis compared to the reference group in which a punch of 4.0 mm was used. Also, the final proximal anastomosis graft size that was measured using cCTA was similar between patients with 4.8-mm punch and patients with 4-mm punch. Results from this study could help to determine which size for aortosaphenous anastomosis is clinically optimal.
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Mehmet
M
Kaya
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Taner
T
İyigün
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Mugisha
M
Kyaruzi
Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Okan
O
Akıncı
Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Hafize
H
Otcu
Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Mehmet
M
Gül
Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Aydın Rodi
AR
Tosu
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul. drmehmetkaya@yahoo.com.
Mehmet
M
Yeniterzi
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods*; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D016896:Treatment Outcome