The Patency of Sequential and Individual Vein Coronary Bypass Grafts: A Systematic Review

Lǐ, Jiànróng; Liu, Yongmin; Zheng, Jun; Bai, Tao; Liu, Yuyong; Wang, Xiaolong; Liu, Ningning; Cheng, Lijian; Chen, Yu; Zhang, Hongjia

doi:10.1016/j.athoracsur.2011.05.038

Cited by 49 publications

(47 citation statements)

References 20 publications

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“…Some series have reported better TTF measurements (16,17) or patency (15,18) results with sequential grafting strategy compared to single graft while others have not (19)(20)(21). A meta-analysis of 12 studies comparing the patency of sequential and individual vein grafts concluded that the mid-and long-term patency of sequential vein grafts were superior to single vein grafts (14). Authors did not report the proportion of on-pump versus off-pump surgery, but none of these studies directly compared coronary graft TTF or patency in sequential grafts performed on-pump versus off-pump.…”

Section: Coronary Graft Flow Measurementmentioning

confidence: 99%

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Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

et al. 2014

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Objectives Intraoperative assessment of coronary artery bypass grafts (CABG) anastomotic quality can be performed using transit-time flowmetry (TTF). The aim of this study was to compare on- versus off-pump coronary graft TTF and early postoperative outcomes. Materials and methods Between January 2009 and January 2010, 521 distal graft flows were assessed using TTF measurements in 253 consecutive patients undergoing primary isolated CABG surgery. Data were analyzed using multilevel models accounting for clustering among surgeons and grafts performed in the same patient. Results Mean age was 66 ± 10 years and 22% were female (n = 55) with 34% diabetics (n = 86) and 40% pre-operative myocardial infarction (MI) (n = 101). The surgeries were performed off-pump in 67% (n = 170) with sequential vein grafts in 57% (n = 144) of patients. Off-pump patients had higher pre-operative left ventricular ejection fractions (LVEF), fewer urgent surgeries, fewer distal anastomoses, and fewer sequential vein grafts (all p<0.001). Intra-operative coronary graft TTF measurements were lower in sequential vein grafts performed off-pump versus on-pump. More patients in the on-pump group needed milrinone or dobutamine 24-48 h postoperatively (p = 0.005). Independent predictors of lower TTF included female gender and off-pump surgery, whereas predictors of better TTF were pre-operative MI, larger coronary diameter at the site of the distal anastomosis, and sequential vein grafting. Conclusions Lower intra-operative TTF measurements were found in sequential vein grafts in offpump CABG. However, off-pump patients experienced similar short-term outcomes compared to on-pump patients.

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Section: Coronary Graft Flow Measurementmentioning

confidence: 99%

“…Sequential grafting leads to a greater outflow bed and lower overall vascular resistances compared to nonsequential grafts (14). Increased graft flow rate has been associated with decreased SVG intimal proliferation (15).…”

Section: Coronary Graft Flow Measurementmentioning

confidence: 99%

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

et al. 2014

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“…The SB is an effective multiple-bypass technique when graft availability is limited [3], and has been reported to allow improved rates of patency in bypass procedures on narrow coronary arteries [4,5]. Compared with regular end-to-side anastomosis, however, side-to-side anastomosis is a relatively complex procedure.…”

Section: Techniquementioning

confidence: 99%

“…(B) Next, the target coronary artery (CA) for anastomosis is opened lengthwise and 2 needles are placed across it using double-armed polypropylene sutures (3,4). (C) One side of the double armed needles (2) is placed on the graft to the proximal side of the target CA from inside to outside and ligated.…”

Section: Techniquementioning

confidence: 99%

Four-Stitch Side-to-Side Anastomosis for Sequential Coronary Artery Bypass Grafting

Tashiro

Wada

Minematsu

et al. 2015

The Annals of Thoracic Surgery

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“…Annual graft occlusion occurs at a level of 2%, meaning that after 10 years, 60% of grafts are patent, although recent studies using a nontouch preparation technique refute these results. (23,24,25) …”

Section: Great Saphenous Vein (Gsv)mentioning

confidence: 99%

Review Up-to-Date Coronary Artery Bypass Graft Surgery

Pandur¹

2015

Scientific Symposium Acquired Heart Diseases. World Heart Day 2014. Proceedings

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The experimental and clinical efforts of Demikov and Kolesov between 1952 and 1964 related to coronary anastomosis between the internal thoracic artery and left anterior descending artery on a beating heart. Sones and Shirey (Cleveland, 1962) were pioneers of selective coronary angiography. The first coronary artery bypass grafting using a saphenous vein graft was performed by Garrett, Dennis, and DeBakey in Houston in 1964. Since that time, coronary surgery has become one of the most frequently performed surgical procedures in the world.Coronarography can be considered the golden standard of diagnostics. Current supplements to coronarography are: functional assesment of the fractional flow reserve; intravascular ultrasound; and optical coherence tomography, for the estimation of atherosclerotic plaque. When combined, these techniques provide high-quality diagnoses. Diagnostic coronarography is followed by percutaneous coronary procedures, the results of which are comparable to those of coronary surgery.Prerequisites of coronary artery bypass grafting (CABG) are grafts and vascular conduits. Alternative flow into ischaemic myocardial territory takes place across these vascular conduits. Usage of the left internal mammary artery is a proven superior standard in operative surgery, due to its better survival rates and prevention of massive myocardial reinfarction. Saphenous vein grafts are most frequently used in the myocardial territory that is not supplied by the left anterior descending artery. In 2018, we will have the final results of the ART trial, which is testing the usage of arterial grafts in coronary surgery. Preliminary results show superiority of the right internal mammary artery as a graft when compared with other arterial grafts (except the left internal mammary artery).Nowadays, myocardial revascularisation with cardiopulmonary bypass is perfomed in 75-80% of cases. Off-pump coronary artery bypass (beating heart) surgery is performed in 20% of cases. Besides these procedures, there are less invasive procedures such as minimal invasive direct coronary bypass (MIDCAB), totally endoscopic coronary bypass (TECAB) and 71 myocardial laser revascularisation. Results of the perioperative application of stem cells and drugs for neoangiogenesis remain limited, in spite of some promising reports.International guidelines from 2011, 2012 and 2013 give us an excellent framework for routine daily practice, but trials such as SYNTAX I and II (2013) and FAME I and II (2013, 2015 will provide new inputs to diagnostic procedures, decision making processes, development, and the need for modern CABG.

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The Patency of Sequential and Individual Vein Coronary Bypass Grafts: A Systematic Review

Cited by 49 publications

References 20 publications

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

Four-Stitch Side-to-Side Anastomosis for Sequential Coronary Artery Bypass Grafting

Review Up-to-Date Coronary Artery Bypass Graft Surgery

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