Document Detail


Comparison of saphenous vein graft versus right gastroepiploic artery to revascularize the right coronary artery: a prospective randomized clinical, functional, and angiographic midterm evaluation.
MedLine Citation:
PMID:  18692661     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Despite its theoretic advantage over saphenous vein grafts, the right gastroepiploic artery graft has not been accepted as the ideal conduit to revascularize the right coronary artery. We therefore prospectively randomized these 2 grafts types to compare their clinical, functional, and angiographic evolution at 6 months and 3 years. METHODS: From 2003 to 2006, 1397 consecutive patients underwent isolated revascularization at the University of Louvain Medical School. Of this group, 370 patients met the inclusion criteria for randomization and 66% of those were randomized. The right coronary artery was revascularized with saphenous vein grafts in 116 patients and with right gastroepiploic arteries in 122 patients. All patients underwent angiographic control 6 months postoperatively. The end points were major adverse cerebrocardiovascular events and proportion of grafts patent or functional at follow-up angiography. RESULTS: There were no significant differences between the 2 groups in terms of hospital events. At follow-up there was no significant difference in major adverse cerebrocardiovascular events between the 2 groups. At the 6-month angiographic follow-up, 91% of the anastomoses in the right gastroepiploic artery group and 95% of the anastomoses in the saphenous vein graft group were controlled patent (P = .92). In nonoccluded right coronary arteries, the proportion of patent grafts was significantly lower and the proportion of nonfunctioning grafts was significantly higher in the right gastroepiploic artery group than in the saphenous vein graft group. CONCLUSION: There were no significant patency or major adverse cerebrocardiovascular events rate differences between the 2 groups; however, the number of functional grafts was significantly higher in the saphenous vein graft group. Careful selection of the coronary target is mandatory to obtain good results in gastroepiploic artery grafting.
Authors:
David Glineur; Claude Hanet; Alain Poncelet; William D'hoore; Jean-Christophe Funken; Jean Rubay; Parla Astarci; Valerie Lacroix; Robert Verhelst; Pierre Yves Etienne; Philippe Noirhomme; Gebrine El Khoury
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-05-19
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  136     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-11     Completed Date:  2008-08-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  482-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine and Surgery, University of Louvain Medical School, Brussels, Belgium. david.glineur@clin.ucl.ac.be
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography*
Coronary Artery Bypass / adverse effects,  methods*
Exercise Test
Female
Gastroepiploic Artery / transplantation*
Graft Occlusion, Vascular / diagnosis
Humans
Male
Middle Aged
Postoperative Complications
Saphenous Vein / transplantation*
Vascular Patency

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


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