Department of Interventional Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
BMC Cardiovasc Disord. 2009 Dec 8;9:53. doi: 10.1186/1471-2261-9-53.
Coronary artery bypass graft (CABG) surgery is the standard of care in the treatment of advanced coronary artery disease, and its long-term results are affected by the failure of bypass grafts. The aim of the present study was to evaluate the early patency rate in coronary bypass grafts.
A total of 107 consecutive patients who underwent CABG were included in this study. Early graft patency was evaluated via computed tomography (CT) angiography in the first week after surgery.
There were a total of 366 grafts, comprised of 250 venous grafts and 116 arterial grafts. Multi-slice CT detected acute graft occlusions in 32 (8.7%) of all the grafts, including 26 (10%) of the 250 venous grafts and 6 (5%) of the 116 arterial grafts. The patency rates obtained were 97.3% for the left internal mammary (IMA) grafts, 50% for the radial artery grafts, and 50% for the right IMA grafts. Additionally, 107 (96.4%) grafts to the left anterior descending artery (LAD) were classified as patent, whereas 1 (30%) of the 3 grafts in the left circumflex (LCX) region and 1 (50%) of the 2 grafts in the right coronary artery (RCA) territory were found to be occluded. In the venous category, 8 (13.7%) of the 58 grafts to LAD were found to be occluded. In the LCX region, 9 (8.5%) of the 106 grafts were classified as occluded, while the remaining 97 (91.5%) grafts were patent. The venous grafts to RCA were occluded in 9 (10.4%) of the 86 grafts. Amongst the multiple preoperative, intraoperative, and postoperative factors, pump time was significantly longer in the patients with occluded grafts than in those with patent grafts (P=0.04).
The IMA grafts had the highest early patency rate amongst the coronary bypass grafts. However, the other arterial grafts were associated with a high rate of acute occlusions.
冠状动脉旁路移植术（CABG）是治疗晚期冠状动脉疾病的标准治疗方法，其长期结果受到旁路移植失败的影响。本研究旨在评估冠状动脉旁路移植术后早期通畅率。
本研究共纳入 107 例连续接受 CABG 的患者。术后第一周通过计算机断层扫描（CT）血管造影评估早期移植物通畅情况。
共有 366 个移植物，其中包括 250 个静脉移植物和 116 个动脉移植物。多层 CT 检测到所有移植物中有 32 个（8.7%）发生急性移植物闭塞，其中 250 个静脉移植物中有 26 个（10%），116 个动脉移植物中有 6 个（5%）。左内乳动脉（IMA）移植物的通畅率为 97.3%，桡动脉移植物为 50%，右 IMA 移植物为 50%。此外，107 个（96.4%）前降支（LAD）的移植物被分类为通畅，而回旋支（LCX）区域的 3 个移植物中的 1 个（30%）和右冠状动脉（RCA）区域的 2 个移植物中的 1 个（50%）被发现闭塞。在静脉组中，58 个 LAD 移植物中有 8 个（13.7%）闭塞。在 LCX 区域，106 个移植物中有 9 个（8.5%）被分类为闭塞，而其余 97 个（91.5%）移植物是通畅的。86 个 RCA 静脉移植物中有 9 个（10.4%）闭塞。在多个术前、术中及术后因素中，闭塞组患者的泵时间明显长于通畅组（P=0.04）。
在冠状动脉旁路移植术中，IMA 移植物具有最高的早期通畅率。然而，其他动脉移植物急性闭塞率较高。
