Gaudino Mario, Niccoli Giampaolo, Roberto Marco, Cammertoni Federico, Cosentino Nicola, Falcioni Elena, Panebianco Mario, D'Amario Domenico, Crea Filippo, Massetti Massimo
From the Department of Cardiovascular Science, Catholic University of the Sacred Heart, Rome, Italy.
Medicine (Baltimore). 2016 Jan;95(1):e2068. doi: 10.1097/MD.0000000000002068.
To evaluate the value of angiographic factors in predicting failure of both venous and arterial coronary artery bypass graft. We retrieved from our angiographic database 148 patients who underwent venous and/or arterial CABG and for whom a control coronary angiography at more than 1 month after surgery was available. Pre-CABG and follow-up angiographies were analyzed in order to evaluate diameter stenosis (DS,%), stenosis length (mm), Bogaty score (extent index), Sullivan score, and Gensini score for the extent of coronary artery disease, and Jeopardy Duke score for the extent of myocardial area supplied by an artery. Thirty-nine patients (26%) experienced graft failure at follow-up (mean follow-up 11.3 ± 4.6 months). Patients with venous graft failure [26 (20%)] had significantly smaller DS (P = 0.013), shorter stenosis length (P = 0.01), and lower extent index (P = 0.015), Sullivan score (P = 0.013), Gensini score (P = 0.04) as compared with those without venous graft failure. Patients with arterial graft failure [13 (11%)] had significantly lower DS (P = 0.008), shorter stenosis length (P = 0.001), and lower extent index (P = 0.03) and Sullivan score (P = 0.023) as compared with those without arterial graft failure. Venous and arterial graft failure are associated with less severe stenosis and less extensive atherosclerosis of the grafted vessel.
评估血管造影因素在预测静脉和动脉冠状动脉旁路移植失败中的价值。我们从血管造影数据库中检索出148例行静脉和/或动脉冠状动脉旁路移植术且术后1个月以上有冠状动脉造影对照的患者。分析冠状动脉旁路移植术前和随访时的血管造影,以评估冠状动脉疾病程度的直径狭窄(DS,%)、狭窄长度(mm)、博加蒂评分(范围指数)、沙利文评分和詹西尼评分,以及动脉供血心肌面积范围的危险杜克评分。39例患者(26%)在随访时出现移植失败(平均随访11.3±4.6个月)。与无静脉移植失败的患者相比,静脉移植失败的患者[26例(20%)]的DS明显更小(P = 0.013),狭窄长度更短(P = 0.01),范围指数更低(P = 0.015),沙利文评分更低(P = 0.013),詹西尼评分更低(P = 0.04)。与无动脉移植失败的患者相比,动脉移植失败的患者[13例(11%)]的DS明显更低(P = 0.008),狭窄长度更短(P = 0.001),范围指数更低(P = 0.03),沙利文评分更低(P = 0.023)。静脉和动脉移植失败与移植血管狭窄程度较轻和动脉粥样硬化范围较小有关。