Predictors of early graft patency following coronary artery bypass surgery.

BACKGROUND

The long-term success of coronary artery bypass graft surgery (CABG) is dependent on graft patency after the operation. Early occlusion (within the first week) affects the long-term results. Therefore, we sought to determine pre-operative, intraoperative, and perioperative factors associated with early coronary graft patency.

METHODS

Between March 2007 and March 2008, 107 consecutive patients (81 men, 26 women, mean age 60 +/- 9 years) who underwent CABG were included in this study. The enrolled patients underwent 16-slice computed tomography angiography one week after CABG.

RESULTS

Based on the multislice computed tomography, acute graft occlusion was detected in 32 (8.7% of all) grafts, including 26 of 250 (10%) in venous grafts and 6 of 116 (5%) in arterial grafts. In univariate analysis, patients with patent coronary grafts had a lower serum glucose level (119 +/- 30 vs. 141 +/- 65 mg/dL, p = 0.02) and longer partial thromboplastin time (34 +/- 11 vs. 30 +/- 2 s, p = = 0.04). In addition, pump time was significantly longer in patients with occluded grafts than in those with patent grafts (119 +/- 43 vs. 102 +/- 32 min, p = 0.04). Those with longer pump time required more coronary grafts (pump time > or = 120 min for 3.5 grafts vs. pump time < 120 min for 2.9 grafts, p = 0.02). Of the multiple pre-operative, intraoperative, and perioperative characteristics of the patients who underwent successful CABG, serum glucose level (OR: 2.014, 95% CI: 1.002-3.026, p = 0.002) and pump time < two hours (OR: 1.502, 95% CI: 1.001-2.030, p = 0.003) were the only predictors of coronary graft patency seven days after surgery in multivariate analysis.

CONCLUSIONS

Our study demonstrated that the patients with successful CABG and patent coronary grafts within the first week after surgery had optimal blood glucose control and pump time < two hours.