Document Detail

Angiographic predictors of 3-year patency of bypass grafts implanted on the right coronary artery system: A prospective randomized comparison of gastroepiploic artery, saphenous vein, and right internal thoracic artery grafts.
MedLine Citation:
PMID:  22014339     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: Saphenous vein, in situ right gastroepiploic artery, and right internal thoracic artery grafts are routinely used to revascularize the right coronary artery. Little is known about the predictive value of objective preoperative angiographic parameters on midterm graft patency.
METHODS: We prospectively enrolled 210 consecutive patients undergoing coronary revascularization. Revascularization of the right coronary artery was randomly performed with the saphenous vein grafts in 81 patients and the right gastroepiploic artery in 92 patients. During the same study period, 37 patients received right coronary artery revascularization with the right internal thoracic artery used in a Y-composite fashion. All patients underwent a protocol-driven coronary angiogram 3 years after surgery. Preoperative angiographic parameters included minimum lumen diameter percent stenosis measured by quantitative angiography. A graft was considered "not functional" with patency scores of 0 to 2 and "functional" with patency scores of 3 or 4.
RESULTS: Angiographic follow-up was 100% complete. A significant difference in the distribution of flow patterns was observed in the 3 groups. In multivariate analysis, the use of a saphenous vein graft was associated with superior graft functionality compared with the other conduits (odds ratio, 6.1; 95% confidence interval, 2.4-15). Graft function was negatively influenced by the minimum lumen diameter (odds ratio, 0.11; confidence interval, 0.05-0.25). In the right gastroepiploic artery and right internal thoracic artery groups, the proportion of functional grafts was higher when the minimum lumen diameter was below a threshold value in the third minimum lumen diameter quartile (0.64-1.30 mm).
CONCLUSIONS: Preoperative angiography predicts graft patency in the right gastroepiploic artery and right internal thoracic artery, whereas the flow pattern in saphenous vein grafts is significantly less influenced by quantitative angiographic parameters.
David Glineur; William D'hoore; Laurent de Kerchove; Philippe Noirhomme; Joel Price; Claude Hanet; Gebrine El Khoury
Related Documents :
16698599 - Diagnosis and management of extrahepatic portal vein aneurysm: a case report.
3722789 - Comparison of splenoportography and transhepatic portography in the diagnosis of portal...
7457189 - Percutaneous transhepatic portography in pancreatic carcinoma. diagnosis and evaluation...
7889709 - Congenital anomalies of the portal venous system--ct appearances with embryological con...
8975979 - Portal vein graft rectal evacuation after whipple procedure. the fabrizio's disease.
9766049 - Gadolinium-enhanced magnetic resonance venography of the portal venous system prior to ...
17398179 - Comparison between angiography and fractional flow reserve versus single-photon emissio...
2814749 - Analysis of benefit of anticoagulation after placement of kimray-greenfield filter.
23978639 - Recent progress in the diagnosis and management of chronic thromboembolic pulmonary hyp...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  142     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  980-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Department of Cardiovascular Medicine and Surgery, Cliniques Universitaire St Luc, Brussels, Belgium.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Topical bioequivalence of acyclovir creams using dermal microdialysis in pigs: a new model to evalua...
Next Document:  Statin therapy attenuates growth and malignant potential of human esophageal adenocarcinoma cells.