Ji Qiang, Song Kai, Xia LiMin, Shi YunQing, Ma RunHua, Shen JinQiang, Ding WenJun, Wang ChunSheng
Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University.
Shanghai Institute of Cardiovascular Disease.
Int Heart J. 2018 Nov 28;59(6):1211-1218. doi: 10.1536/ihj.17-639. Epub 2018 Oct 10.
The enormous majority of previous reports focused on evaluating the safety and efficacy of sequential saphenous vein (SV) coronary bypass grafting; however, no reports to date have revealed concern regarding the impacts of the number of distal anastomoses of sequential SV grafting on graft patency after coronary artery bypass grafting (CABG). This single-center retrospective study aimed to evaluate the impacts of three versus two distal anastomoses per single SV conduit on SV graft patency after off-pump CABG, and to determine the independent risk factors for sequential SV graft failure.From January 2011 to December 2014, 1320 eligible patients were assigned to either a triple group (three distal anastomoses of sequential SV grafting, n = 758) or a double group (two distal anastomoses of sequential SV grafting, n = 562). The primary endpoint was over a 2-year follow-up SV graft failure after off-pump CABG.The triple and double group received a similar total patency rate of sequential SV conduits (86.5% versus 87.1%, P = 0.757). The number of distal anastomoses of sequential SV grafting (three versus two) was not a predictive factor for the follow-up graft failure of sequential SV conduits (HR = 0.91, 95% CI: 0.66-2.29, P = 0.137). Moreover, the two groups received a similar follow-up survival freedom from repeat revascularization (χ = 1.881, log-rank P = 0.170).Three versus two distal anastomoses per single SV conduit received a similar SV graft patency. The number of distal anastomoses of sequential SV grafting was not an independent risk factor for graft failure.
以往绝大多数报告聚焦于评估序贯大隐静脉(SV)冠状动脉旁路移植术的安全性和有效性;然而,迄今为止尚无报告表明关注序贯SV移植术中远端吻合口数量对冠状动脉旁路移植术(CABG)后移植血管通畅性的影响。本单中心回顾性研究旨在评估非体外循环CABG术后单根SV血管进行三个远端吻合与两个远端吻合对SV移植血管通畅性的影响,并确定序贯SV移植血管失败的独立危险因素。
2011年1月至2014年12月,1320例符合条件的患者被分为三组(序贯SV移植三个远端吻合,n = 758)或两组(序贯SV移植两个远端吻合,n = 562)。主要终点是在非体外循环CABG术后2年的随访期内SV移植血管失败。
三组和两组序贯SV血管的总通畅率相似(86.5%对87.1%,P = 0.757)。序贯SV移植的远端吻合口数量(三个对两个)不是序贯SV血管随访期移植失败的预测因素(HR = 0.91,95%CI:0.66 - 2.29,P = 0.137)。此外,两组在随访期免于再次血运重建的生存率相似(χ = 1.881,对数秩检验P = 0.170)。
单根SV血管进行三个远端吻合与两个远端吻合的SV移植血管通畅率相似。序贯SV移植的远端吻合口数量不是移植失败的独立危险因素。