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

Tinică, Grigore

doi:10.14744/anatoljcardiol.2018.51447

Cited by 27 publications

(39 citation statements)

References 26 publications

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“…As we know that competitive flow is a predictor of early arterial graft failure, some authors recommend SVG for bypassing the right coronary artery (RCA) with moderate stenosis [ 1 ]. The SVG patency rate was not sensitive to target vessel degree of stenosis as it was perfused directly from the aorta with higher pressures compared with arterial grafts [ 28 ]. This was a pilot study where we evaluated the impact of the native coronary artery stenosis measured by iFR on graft flow regardless of graft type—arterial or venous.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts

et al. 2020

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Background and Objectives: To assess the correlation between the degree of target coronary artery stenosis measured by instantaneous wave-free ratio (iFR) and the intraoperative transit time flow measurement (TTFM) of attached grafts as well as evaluate flow competition between the native coronary artery and the attached graft according to the severity of stenosis. Materials and Methods: In total, 89 grafts were subjected to intraoperative transit time flow measurement after coronary artery bypass grafting (CABG) in 25 patients with multivessel coronary artery disease (CAD). The iFR was evaluated for all coronary arteries with grafts. The coronary artery stenoses were divided into three groups based on the iFR value: iFR < 0.86 (group 1); iFR 0.86–0.90 (group 2); and iFR > 0.90 (group 3). Results: The mean graft flow (MGF) was 46.9 ± 18.4 mL/min for group 1, 45.3 ± 20.9 mL/min for group 2, and 31.3 ± 18.5 mL/min for group 3. A statistically significant difference was confirmed between groups 1 and 3 (p = 0.002) and between groups 2 and 3 (p = 0.025). The pulsatility index (PI) was 2.49 ± 1.20 for group 1, 2.66 ± 2.13 for group 2, and 4.70 ± 3.66 for group 3. A statistically significant difference was found between groups 1 and 3 (p = 0.006) and between groups 2 and 3 (p = 0.032). Backward flow was detected in 7.5% of grafts for group 1, in 16.6% of grafts for group 2, and in 16% of grafts for group 3. A statistically significant difference was found between groups 1 and 2 (p = 0.025) and between groups 1 and 3 (p = 0.029). Conclusions: The iFR is a useful tool for predicting the impact of competitive flow observed between a native artery and an attached graft. The effect of competitive flow significantly increases when the graft is attached to a vessel with mild coronary stenosis. In a coronary artery where the iFR was not hemodynamically significant, the MGF was lower, the PI was higher, and a larger proportion of grafts with backward flow (BF) was detected compared to when there was significant stenosis (iFR < 0.86).

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Section: Discussionmentioning

confidence: 99%

Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts

et al. 2020

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“…The main failure reason, in the late phase, for left internal mammary artery graft is competitive flow from residual blood flow from the native coronary artery [ 6 ]. In contrast, the suboptimal, but most commonly used graft, is saphenous vein that displays a relatively low long-term patency rate of 61% after 10 years [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Review: Tissue Engineering of Small-Diameter Vascular Grafts and Their In Vivo Evaluation in Large Animals and Humans

Fang

Ellman

Andersen

2021

Cells

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To date, a wide range of materials, from synthetic to natural or a mixture of these, has been explored, modified, and examined as small-diameter tissue-engineered vascular grafts (SD-TEVGs) for tissue regeneration either in vitro or in vivo. However, very limited success has been achieved due to mechanical failure, thrombogenicity or intimal hyperplasia, and improvements of the SD-TEVG design are thus required. Here, in vivo studies investigating novel and relative long (10 times of the inner diameter) SD-TEVGs in large animal models and humans are identified and discussed, with emphasis on graft outcome based on model- and graft-related conditions. Only a few types of synthetic polymer-based SD-TEVGs have been evaluated in large-animal models and reflect limited success. However, some polymers, such as polycaprolactone (PCL), show favorable biocompatibility and potential to be further modified and improved in the form of hybrid grafts. Natural polymer- and cell-secreted extracellular matrix (ECM)-based SD-TEVGs tested in large animals still fail due to a weak strength or thrombogenicity. Similarly, native ECM-based SD-TEVGs and in-vitro-developed hybrid SD-TEVGs that contain xenogeneic molecules or matrix seem related to a harmful graft outcome. In contrast, allogeneic native ECM-based SD-TEVGs, in-vitro-developed hybrid SD-TEVGs with allogeneic banked human cells or isolated autologous stem cells, and in-body tissue architecture (IBTA)-based SD-TEVGs seem to be promising for the future, since they are suitable in dimension, mechanical strength, biocompatibility, and availability.

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“…En contraparte, los resultados del uso de PAC venosos tienden a ser inferiores con tasas de reestenosis que pueden alcanzar entre 10 -20% al año 7 y hasta 40-50% a 10 años 8 . Sin embargo, otras series actuales muestran una mejoría al respecto con permeabilidades de hasta 86,4% a 5 años 9 y 74,3% a 10 años 10 . Por otro lado, los nuevos stents medicados de segunda o tercera generación han mostrado mejorías significativas respecto de aquellos de primera generación.…”

Section: Fundamento Teóricounclassified

Revascularización coronaria híbrida: un punto de encuentro entre Cardiólogos Intervencionistas y Cirujanos Cardíacos

et al. 2020

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La revascularización coronaria híbrida busca combinar el beneficio de las técnicas quirúrgicas y percutáneas para un manejo óptimo de pacientes seleccionados con enfermedad coronaria obstructiva multivaso. Esto permite asociar el beneficio del puente de arteria mamaria interna izquierda a la arteria descendente anterior (ADA) y combinarlo con el implante de stents en lesiones no-ADA. El objetivo de este tra-bajo es hacer una revisión de la literatura disponible con énfasis en sus resultados clínicos comparados con la estrategia convencional. Palabras clave: Revascularización híbrida coronaria, enfermedad de arteria coronaria, cirugía de bypass de arteria coronaria, intervención coronaria percutánea.

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

Cited by 27 publications

References 26 publications

Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts

Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts

Review: Tissue Engineering of Small-Diameter Vascular Grafts and Their In Vivo Evaluation in Large Animals and Humans

Revascularización coronaria híbrida: un punto de encuentro entre Cardiólogos Intervencionistas y Cirujanos Cardíacos

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