Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery

Abstract

The 10-year patency of IMA grafts is better than SVGs. The 10-year patency for SVGs is better and the 10-year patency for IMA grafts is worse than expected. The 10-year patency of SVGs to the LAD is better than that to the right or circumflex. The best long-term predictors of SVG graft patency are grafting into the LAD and grafting into a vessel that is >2.0 mm in diameter.

c-Jun Regulates Shear- and Injury-inducible Egr-1 Expression, Vein Graft Stenosis after Autologous End-to-Side Transplantation in Rabbits, and Intimal Hyperplasia in Human Saphenous Veins

“…Coronary artery bypass grafting (CABG) 2 remains one of the most widely used surgical means of treating coronary heart disease after heart attack (1,2). Venous graft occlusion is the major cause of recurrent ischemia in patients after CABG.…”

Secondary Prevention After Coronary Artery Bypass Graft Surgery

“…Nevertheless, the adverse effects of diabetes mellitus on graft patency have not been seen in all studies. For example, in a 10-year follow-up of the VA Cooperative Study involving 1074 CABG patients, Goldman et al 282 did not find diabetes mellitus to be an independent predictor of vein graft failure. Most recently, in a long-term observational study evaluating risk factors for adverse outcomes after CABG, Sabik et al 164 reported that diabetes mellitus was a strong risk factor for coronary reintervention (either percutaneous coronary intervention or redo CABG) in the years after CABG.…”

Internal mammary artery conduit re-use in coronary artery bypass grafting: Case series and review

“…[1,2] The LIMA is a unique artery in that it is more resistant to atherosclerosis due to its resilient endothelium and nonfenestrated internal elastic lamina that is resistant to smooth muscle migration. [2] In addition, the lumen of the LIMA is very close in size to that of the LAD, allowing for less turbulent flow after anastomosis.…”

“…All of these reasons mean that the LIMA to LAD has a superior 10 year patency to any other coronary bypass graft. [1,2] In situations where there is stenosis in the LAD distally to the original anastomosis, it would be ideal to take advantage of the well-documented benefits of this graft. Unfortunately, in re-operative CABGs adhesions around the LIMA can make it difficult to free and mobilize adequate length.…”

“…[1] The recycling of the LIMA graft is an excellent option when there is concern for conduit availability. We present two consecutive patients who underwent redo-revascularization with re-use LIMA grafting.…”