Therapeutic-Dose Warfarin (International Normalized Ratio &gt;1.6) Plus Aspirin Improved Long-Term Patency of Saphenous Vein Graft without Bleeding Complication

Tasaki, Dai; Arai, Hirokuni; Yokoyama, Kenji; Yoshizaki, Tomoya

doi:10.5761/atcs.oa.21-00236

Cited by 1 publication

(1 citation statement)

References 33 publications

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“…Warfarin was postoperatively administered to more than two-thirds of eligible patients (67.3%), because our previous study showed that its therapeutic dose in combination with aspirin improves long-term venous graft patency. 15 All patients underwent early postoperative (13.3±6.3 days) and 1-year (12.8±2.8 months) angiographic evaluations. The GEA anastomotic diameter was 2.70±0.58 mm at the early postoperative evaluation.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Preoperative Computed Tomography of the Right Gastroepiploic Artery for Coronary Artery Bypass Grafting

Yokoyama

Yoshizaki

Nagaoka

et al. 2023

Circ J

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Background: Grafting the right gastroepiploic artery (GEA) to the right coronary artery (RCA) is effective, but preoperative evaluation of arterial conduit availability has not been established. By comparing the midterm graft results, we aimed to assess the efficacy of preoperative evaluation of the GEA using computed tomography (CT). Methods and Results:We retrospectively examined patients who underwent isolated coronary artery bypass grafting surgery between April 2010 and December 2020, and those whose GEA was grafted to the RCA were selected: 55 patients were included in the study analysis. Postoperative evaluations were performed during the early phase, 1 year postoperatively, and at follow-up evaluations. The outer diameter of the proximal GEA was compared with the midterm graft patency grade on CT and patients were classified as Functional (Grade A) or Dysfunctional (Grades O or B). The proximal GEA outer diameters were significantly different between the Functional and Dysfunctional groups (P<0.001). Furthermore, multivariate Cox regression analysis revealed that this diameter was an independent predictor of graft functionality (P<0.001). Patients with outer proximal diameters larger than the cutoff value had superior graft results at 3 years postoperatively. The rate of freedom from a dysfunctional graft at 3 years postoperatively was 95.5% and 45.5% for the Larger and Smaller diameter subgroups, respectively (P<0.001). Conclusions:Preoperative evaluation of the outer diameter of the proximal GEA, excluding calcified GEA, using CT is a minimally invasive and useful method, and may improve midterm results of in-situ GEA grafting, even in severe stenotic lesions.

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Section: Surgical Proceduresmentioning

confidence: 99%