Graft selection and one-year patency rates in patients undergoing coronary artery bypass grafting

Abstract

Background: The aim of this study was to assess the angiographic patency rates of grafts used for coronary artery bypass surgery.

Methods: We reviewed the records of 930 patients who underwent isolated coronary artery bypass grafting between September 2004 and June 2009. Of these patients, 95.1% underwent off-pump coronary artery bypass grafting. Early and 1-year angiographic patency rates of grafts were assessed.

Results: Mean anastomoses per patient were 4.0 +/- 1.3. Operative mortality was 0.5%. Stroke occurred in 2.2% of patients, and 1.3% had mediastinitis. Early and 1-year patency rate of total grafts was 97.4% and 87.5%, respectively. One-year patency rate of the left internal thoracic artery, right internal thoracic artery, radial artery, gastroepiploic artery, and saphenous vein graft was 96.1%, 92.0%, 69.5%, 81.4%, and 82.6%, respectively. One-year patency rates of in situ and free right internal artery graft were not significantly different (p = 0.13). One-year patency rate of the radial artery was significantly worse than that of the free right internal thoracic artery graft (p < 0.01) and saphenous vein graft (p < 0.01).

Conclusions: Multiple coronary arterial revascularizations in various combinations of grafts were clinically safe and effective for isolated coronary artery bypass surgery. Bilateral internal thoracic artery grafting for the left coronary artery system was the most reliable strategy as shown by angiographic patency rates.