Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov;20(5):275-282.
doi: 10.14744/AnatolJCardiol.2018.51447.

Long-term graft patency after coronary artery bypass grafting: Effects of morphological and pathophysiological factors

Grigore Tinica, Raluca Ozana Chistol  1 , Mihail Enache, Maria Magdalena Leon Constantin, Manuela Ciocoiu, Cristina Furnica
Affiliations

Long-term graft patency after coronary artery bypass grafting: Effects of morphological and pathophysiological factors

Grigore Tinica et al. Anatol J Cardiol. 2018 Nov.

Abstract

Objective: The aim of the present study was to identify morphological and pathophysiological factors associated with long-term patency of grafts used in coronary artery bypass grafting (CABG).

Methods: A total of 127 patients who underwent CABG between 2000 and 2006 and presented for computed tomography evaluation of graft patency at 139.78±36.64 months post-CABG were analyzed. Patients received 340 grafts (2.68 grafts/patient), 399 distal anastomoses (3.14 anastomoses/ patient), 220 (55.14%) performed using arterial grafts, and 179 (44.86%) using saphenous vein grafts (SVGs).

Results: Graft patency varied according to vessel type and coronary territory. Overall graft patency was 90.16% for the left internal thoracic artery (LITA), 75.55% for the right internal thoracic artery (RITA), 79.25% for the radial artery (RA), and 74.3% for the SVG. The maximum patency rate was obtained with the RA (80.65%) for the right coronary territory, RITA (92.86%) for the anterolateral territory, and SVG (82.54%) for the circumflex territory. The LITA-left anterior descending artery graft occluded in 13 (7.93%) cases, 7 due to competitive flow. The influence of graft length on patency rates after indexing to height was not significant. The target vessel degree of stenosis influenced arterial graft patency rates with an occlusion odds ratio (OR) of 3.02 when anastomosed to target vessels with <90% stenosis. Target vessel caliber also influenced patency rates with occlusion ORs of 2.63 for SVGs and 2.31 for arterial grafts when anastomosed to ≤1.5 mm target vessels.

Conclusion: Morphological parameters, such as graft type, target territory, target vessel caliber, and degree of stenosis, are important factors conditioning long-term graft patency.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Patent (left) and occluded (right) LITA–LAD graft
Figure 2
Figure 2
RCA diameter downstream from an SVG–RCA anastomosis
Figure 3
Figure 3
RITA passage through the transverse sinus to reach a marginal obtuse artery
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Eurostat-Surgical operations and procedures statistics. [(cited 2017 August 31st)]. Available from: http://ec.europa.eu/eurostat/statistics-explained/index.php/Surgical_ope... .
    1. European Society of Cardiology: ESC/EACTS Guidelines in Myocardial Revascularisation. 2014. [(cited 2017 August 31st)]. Available from: http://eurheartj.oxfordjournals.org/content/ehj/35/37/2541.full.pdf .
    1. Coronary Revascularization Writing Group. Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA, et al. American College of Cardiology Foundation;American College of Cardiology Foundation Appropriate Use Criteria Task Force;Society for Cardiovascular Angiography and Interventions;Society of Thoracic Surgeons;American Association of Thoracic Surgery;American Heart Association;American Society of Nuclear Cardiology;Society of Cardiovascular Computed Tomography. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography. J Thorac Cardiovasc Surg. 2012;143:780–803. - PubMed
    1. Patil CV, Nikolsky E, Boulos M, Grenadier E, Beyar R. Multivessel coronary artery disease: current revascularization strategies. Eur Heart J. 2001;22:1183–97. - PubMed
    1. Sabik JF., 3rd Understanding saphenous vein graft patency. Circulation. 2011;124:273–5. - PubMed