Document Detail

Comparison of saphenous vein and internal thoracic artery graft patency by coronary system.
MedLine Citation:
PMID:  15680832     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We sought to compare saphenous vein and internal thoracic artery graft patency by coronary system. METHODS: From 1972 to 1999, 50,278 patients underwent primary coronary surgery; subsequently, 4,333 had angiography of 2,121 internal thoracic artery and 8,733 saphenous vein grafts. Longitudinal analysis was used to model graft occlusion and identify risk factors. Using the model, patency was calculated twice for each graft and compared first as if an internal thoracic artery, and second as if a saphenous vein, were used. RESULTS: Unadjusted 1-, 5-, and 10-year patency was 93%, 88%, and 90% for internal thoracic arteries and 78%, 65%, and 57% for saphenous veins. At 10 years, internal thoracic arteries were more likely than saphenous veins to be patent to left anterior descending in 99.1% of cases, to diagonals in 98.3%, to circumflex in 98.3%, to posterior descending artery in 98.5%, and to right coronary arteries in 82.5%. For right coronary arteries, saphenous vein patency was equivalent to or better than internal thoracic artery patency early after surgery. However, by 10 years, internal thoracic artery patency was better in right coronary arteries with 70% stenosis or greater. At all times after surgery and all levels of clinically important coronary stenosis, internal thoracic artery patency surpassed saphenous vein patency in grafts to the left anterior descending, diagonal, circumflex, and posterior descending arteries. CONCLUSIONS: Internal thoracic arteries demonstrate better patency than saphenous veins except when grafting moderately stenosed right coronary arteries. When bypassing right coronary arteries with less than 70% stenosis, saphenous veins may be a better choice.
Joseph F Sabik; Bruce W Lytle; Eugene H Blackstone; Penny L Houghtaling; Delos M Cosgrove
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  79     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-31     Completed Date:  2005-09-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  544-51; discussion 544-51     Citation Subset:  AIM; IM    
Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Coronary Angiography
Coronary Stenosis / radiography,  surgery*
Graft Occlusion, Vascular / epidemiology*,  prevention & control,  radiography
Mammary Arteries / radiography,  transplantation*
Middle Aged
Models, Cardiovascular
Risk Factors
Saphenous Vein / radiography,  transplantation*
Treatment Outcome
Vascular Patency*

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

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