Prognosis for aorta-coronary graft patency. A comparison of preoperative and intraoperative assessments

For prognostication of aorta-coronary bypass graft patency, preoperative angiographic assessment of the recipient vessel and the regional left ventricle was compared with the intraoperative measurement of the internal diameter of the vessel and graft flow in 98 patients, in whom graft patency was evaluated at 1 year. Preoperative assessment of the recipient vessel did not correlate with the intraoperative measurement of the internal diameter or with the graft patency. Preoperative assessment of the regional left ventricular wall motion, on the other hand, was more valuable for prognosticating graft patency. Regions assessed as normal or hypokinetic had equally good graft patency, whereas akinetic or dyskinetic areas had only a 54% patency rate. Intraoperative measurement of the internal diameter of the vessel and graft flow were reliable predictors of graft patency: The larger the internal diameter and the greater the graft flow, the better the graft patency. Best surgical results can therefore be predicted when the internal diameter of the recipient vessel is 2.5 mm or more, graft flow is 100 ml/min or more, and the regional left ventricle moves well.