Document Detail


Midterm angiographic follow-up after off-pump coronary artery bypass: serial comparison using early, 1-year, and 5-year postoperative angiograms.
MedLine Citation:
PMID:  18242256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We analyzed the angiographic changes of the anastomotic sites at three time points for 5 years after off-pump coronary artery bypass surgery. METHODS: Of the 402 patients who underwent off-pump coronary artery bypass surgery between January 1998 and December 2001, 240 patients who received the early, 1-year, and 5-year follow-up coronary angiograms regardless of the patient's anginal symptoms were studied. Morphologic changes of grafts were traced by the FitzGibbon grading system. RESULTS: Overall graft patency rates (FitzGibbon grade A+B) at early, 1-year, and 5-year angiography were 98.6%, 91.9%, and 88.3%, respectively. Graft patency rates in the left anterior descending artery, left circumflex artery, and right coronary artery territories were similar at early angiograms (P = .162). However, graft patency rate in the left anterior descending artery territory was higher than that in the left circumflex artery and right coronary artery territories at both the 1-year (P < .001) and 5-year (P < .001) angiograms. Of the 31 FitzGibbon grade B arterial grafts (internal thoracic artery and right gastroepiploic artery) at early angiography, 10 became occluded and 19 became grade A at 5-year angiography. In the saphenous vein grafts, grade B lesions gradually increased during the 5 postoperative years (2.6% vs 6.5% vs 13.3%). CONCLUSIONS: Midterm angiographic follow-up demonstrated acceptable patency rates of grafts after off-pump coronary artery bypass surgery. Approximately half of the FitzGibbon grade B arterial grafts in the early angiograms became grade A at 5 years after surgery, but the proportion of grade B saphenous vein grafts gradually increased over the 5 postoperative years.
Authors:
Ki-Bong Kim; Kwang Ree Cho; Dong Seop Jeong
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  135     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-03-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  300-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. kimkb@snu.ac.kr <kimkb@snu.ac.kr>
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Coronary Angiography / methods*
Coronary Artery Bypass, Off-Pump / methods*
Coronary Restenosis / radiography*
Coronary Stenosis / mortality,  radiography*,  surgery*
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Male
Middle Aged
Postoperative Complications / mortality,  radiography
Probability
Retrospective Studies
Survival Rate
Time Factors
Vascular Patency

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


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