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[Morphological comparison between arterial grafts and venous grafts]
T Sueda1, H Shikata, K Orihashi
1First Department of Surgery, Hiroshima University, School of Medicine, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|September 1, 1994
Summary
Arterial grafts, including the right internal thoracic artery (RITA), left internal thoracic artery (LITA), and right gastroepiploic artery (RGEA), demonstrate superior patency rates in coronary bypass surgery compared to saphenous vein grafts (SVG). RGEA exhibits structural advantages for CABG.
Area of Science:
- Cardiovascular Surgery
- Vascular Biology
- Biomedical Engineering
Background:
- Arterial grafts are preferred for coronary bypass surgery (CABG) due to higher patency rates.
- Internal thoracic artery (ITA) and gastroepiploic artery (GEA) are commonly used arterial grafts.
Purpose of the Study:
- To compare the patency rates and pathological characteristics of arterial grafts versus saphenous vein grafts (SVG) in CABG.
- To evaluate the structural suitability of different arterial grafts for coronary artery bypass procedures.
Main Methods:
- Prospective study of 134 CABG patients over 27 months.
- Postoperative angiography to assess graft patency.
- Pathological examination of harvested graft specimens.
Main Results:
- High patency rates for RITA (97%), LITA (98%), and RGEA (96%) compared to SVG (86%).
- Arterial grafts showed underdeveloped vasa vasorum but low atherosclerotic scores.
- RGEA exhibited endothelial morphology similar to coronary arteries, suggesting superior suitability.
Conclusions:
- Arterial grafts, particularly RGEA, offer superior long-term patency and structural characteristics for CABG.
- Endothelial preservation and morphology favor RGEA over ITA and SVG.
- RGEA is a highly suitable graft for coronary bypass surgery due to its structural superiority.