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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

Single versus sequential saphenous vein grafting of the circumflex system: a flowmetric study

Francesco Onorati1, Francesco Pezzo, Antonio Esposito

  • 1Cardiac Surgery Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy. frankono@libero.it

Scandinavian Cardiovascular Journal : SCJ
|August 8, 2007
PubMed

Insights

Sequential vein graft coronary artery bypass grafting (SV-CABG) on two obtuse marginal branches offers superior graft flow compared to single SV-CABG on one branch for circumflex lesions, reducing treatment failure.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Grafting
  • Coronary Artery Disease

Background:

  • Critical circumflex (CX) artery lesions pose challenges in coronary artery bypass grafting (CABG).
  • Optimal surgical strategy for single versus sequential vein grafts (SV-CABG) to obtuse marginal (OM) branches remains debated.

Purpose of the Study:

  • To compare the efficacy of single SV-CABG on the best OM branch versus sequential SV-CABG on two OM branches for patients with proximal CX lesions.

Main Methods:

  • Ninety patients with proximal CX lesions were prospectively randomized into two groups: single SV-CABG (n=45) or sequential SV-CABG (n=45).
  • Graft performance was assessed using transit-time flowmetry (TTF) and graft flow reserve.
  • Treatment failure was defined as recurrent angina, myocardial infarction, or need for reintervention.

Main Results:

  • Sequential SV-CABG demonstrated significantly higher intraoperative maximum, mean, and minimum graft flows (p<0.001).
  • Higher graft flow reserve was observed in the sequential SV-CABG group (p<0.001).
  • Freedom from treatment failure was significantly better in the sequential SV-CABG group (97.5% vs. 88.7%, p=0.05).

Conclusions:

  • Sequential SV-CABG to two OM branches provides superior graft flow and reserve compared to single SV-CABG.
  • This approach is associated with a lower rate of mid-term treatment failure without increased perioperative risk.
Abstract

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