Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Ann Thorac Surg. 2010 Aug;90(2):516-21. doi: 10.1016/j.athoracsur.2010.04.017.
We compared midterm clinical outcomes and 1-year graft patency rates of saphenous vein composite grafts with those of total arterial composite grafts in patients who underwent off-pump coronary artery bypass grafting (OPCAB).
Three hundred forty patients who underwent OPCAB using composite grafts based on the left internal thoracic artery were studied. Total arterial revascularization using arterial composite grafts was performed in 263 patients (ART group) and the saphenous vein was used as an additional composite graft in 77 patients (SVG group). Clinical outcomes and early and 1-year postoperative angiographic results were compared.
No differences in early mortality or perioperative complications were observed between the groups. Early postoperative (1.7 + or - 1.7 days) angiography demonstrated a saphenous vein graft patency rate of 97.1% (132 of 136), which was not different from that of arterial composite grafts (98.7% [631 of 639], p = 0.240). One-year postoperative (12 + or - 1 months) angiography showed an overall patency rate of 93.4% (886 of 949). The patency rate of saphenous vein grafts at 1 year was 92.1% (105 of 114), which was similar to that of arterial composite grafts (91.0% [499 of 550], p = 0.640). Patency rates of venous grafts according to target coronary artery territories were also similar to those of arterial composite grafts. Reintervention-free survival rates at 2 years were 90.6% (ART) and 91.3% (SVG) (p = 0.970). No differences were observed in overall survival rates between the groups (p = 0.792).
Our clinical and angiographic results demonstrated that the saphenous vein may be used as an alternative composite graft to the arterial composite graft.
我们比较了在非体外循环冠状动脉旁路移植术（OPCAB）中使用隐静脉复合移植物与全动脉复合移植物的中期临床结果和 1 年移植物通畅率。
研究了 340 例接受基于左内乳动脉的复合移植物 OPCAB 的患者。263 例患者采用全动脉复合移植物进行动脉血管重建（ART 组），77 例患者采用隐静脉作为附加复合移植物（SVG 组）。比较临床结果和早期及 1 年后术后血管造影结果。
两组患者在早期死亡率或围手术期并发症方面无差异。早期术后（1.7+或-1.7 天）血管造影显示隐静脉移植物通畅率为 97.1%（132/136），与动脉复合移植物（98.7%[631/639]，p=0.240）无差异。1 年后（12+或-1 个月）血管造影显示总体通畅率为 93.4%（886/949）。1 年后隐静脉移植物通畅率为 92.1%（105/114），与动脉复合移植物（91.0%[499/550]，p=0.640）相似。根据靶冠状动脉区域的静脉移植物通畅率也与动脉复合移植物相似。2 年无再介入生存率为 90.6%（ART）和 91.3%（SVG）（p=0.970）。两组患者的总生存率无差异（p=0.792）。
我们的临床和血管造影结果表明，隐静脉可作为动脉复合移植物的替代复合移植物。
