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Complementary saphenous grafting: long-term follow-up
1Cliniques Universitaires Saint-Luc, Brussels, Belgium. r.a.e.dion@lumc.nl
The Journal of Thoracic and Cardiovascular Surgery
|August 2, 2001
Summary
Sequential internal thoracic artery grafting with complementary saphenous grafts shows high long-term patency and excellent freedom from angina. This approach remains a viable option for select patients, especially those with remote coronary artery disease.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Review of 10-year outcomes for sequential internal thoracic artery grafting revealed surprisingly high long-term patency rates.
- Most patients also received complementary saphenous grafts, prompting a detailed analysis of these combined grafting strategies.
Purpose of the Study:
- To analyze in detail the long-term clinical and angiographic outcomes of sequential internal thoracic artery grafting combined with saphenous vein grafts.
- To evaluate the patency and intactness rates of different graft types and anastomoses.
Main Methods:
- Retrospective study of 500 consecutive patients who received at least one sequential internal thoracic artery graft (October 1985 - August 1991).
- Saphenous grafts were used for complete revascularization in addition to arterial grafting.
- Late angiographic restudy was performed on 161 patients at a mean of 7.5 years postoperatively.
Main Results:
- At 10 years, freedom from angina was 82% and freedom from cardiac events was 69%.
- Overall saphenous graft patency was 72.5% and intactness was 60.2%.
- Sequential saphenous grafts demonstrated significantly better patency and intactness than single saphenous grafts.
Conclusions:
- Complementary sequential saphenous grafting is a valuable option for patients under 70, particularly those with disease in distal coronary territories.
- This strategy offers durable results and contributes to complete revascularization.