HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Claude M. Grondin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grondin, C. M. Articles by Campeau, L. Search for Related Content PubMed PubMed Citation Articles by Grondin, C. M. Articles by Campeau, L.

Ann Thorac Surg 1975;20:605-618
© 1975 The Society of Thoracic Surgeons

---

Articles

Coronary Artery Grafting with the Saphenous Vein or Internal Mammary Artery

Comparison of Late Results in Two Consecutive Series of Patients

From the Institut de Cardiologie de Montréal, Montreal, Que., Canada

^* Address reprint requests to Dr. Grondin, Department of Surgery, Institut de Cardiologie de Montréal, 5000 est, rue Belanger, Montreal, Que., Canada, H1T 1C8

In two series of consecutive patients who underwent coronary artery grafting with the saphenous vein or the internal mammary artery (IMA), angiographic studies were conducted two weeks and one year after operation. The early patency rate was 91.8% in 184 vein grafts and 97.4% in 38 IMA grafts. Late patency was 93.1% in 143 vein grafts and 90.9% in 33 IMA grafts. Thus, the cumulative patency rate at one year was 84.9% for vein grafts and 88.3% for IMA grafts.

The incidence of severe narrowing at the site of anastomosis was 2.2% in vein grafts and 7.9% in IMA grafts; the rate of occlusion of the distal limb of the recipient coronary artery was, respectively, 4.3 and 7.9%. Diffuse reduction in the caliber of grafts at one year was less frequent with IMA grafts (12.7 versus 6.6%). On the other hand, blood flow was significantly higher in vein grafts: 67.4 versus 45.2 ml per minute (p < 0.001). Blood flow in IMA grafts whose caliber was larger than that of the recipient coronary artery was significantly higher than flow in IMA grafts with a caliber equal or inferior to that of the coronary artery: 63.1 versus 32.7 ml per minute (p < 0.001).

Although cumulative patency rates at one year were comparable in both series, because only one-third of the IMAs were larger than their recipient coronary arteries, flow was somewhat restricted in the other two-thirds. This suggests that the IMA does not constitute the better bypass conduit and, unless it is of large caliber, preferably should be used in the grafting of small coronary arteries or those with limited runoff.

This article has been cited by other articles:

				M. A. Deja, K. S. Golba, M. Malinowski, S. Wos, M. Kolowca, J. Biernat, M. Kajor, and T. J. Spyt Skeletonization of internal thoracic artery affects its innervation and reactivity Eur J Cardiothorac Surg, October 1, 2005; 28(4): 551 - 557. [Abstract] [Full Text] [PDF]

				R. Dion, D. Glineur, D. Derouck, R. Verhelst, P. Noirhomme, G. El Khoury, E. Degrave, and C. Hanet Complementary saphenous grafting: Long-term follow-up J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 296 - 304. [Abstract] [Full Text] [PDF]

				M. Ojha, R. L. Leask, K. W. Johnston, T. E. David, and J. Butany Histology and morphology of 59 internal thoracic artery grafts and their distal anastomoses Ann. Thorac. Surg., October 1, 2000; 70(4): 1338 - 1344. [Abstract] [Full Text] [PDF]

				J. T. Christenson and M. Schmuziger Sequential Venous Bypass Grafts: Results 10 Years Later Ann. Thorac. Surg., February 1, 1997; 63(2): 371 - 376. [Abstract] [Full Text]

				C. Schmid, B. Heublein, S. Reichelt, and H. G. Borst Steal phenomenon caused by a parallel branch of the internal mammary artery Ann. Thorac. Surg., September 1, 1990; 50(3): 463 - 464. [Abstract] [PDF]

				S. S. Khan, S. Nessim, R. Gray, L. S. Czer, A. Chaux, and J. Matloff Increased Mortality of Women in Coronary Artery Bypass Surgery: Evidence for Referral Bias Ann Intern Med, April 15, 1990; 112(8): 561 - 567. [Abstract] [PDF]

				E. L. Jones, O. Lattouf, J. F. Lutz, and S. B. King III Important Anatomical and Physiological Considerations in Performance of Complex Mammary-Coronary Artery Operations Ann. Thorac. Surg., May 1, 1987; 43(5): 469 - 477. [Abstract] [PDF]

				R. N. Singh, R. A. Beg, and E. B. Kay Physiological Adaptability: The Secret of Success of the Internal Mammary Artery Grafts Ann. Thorac. Surg., March 1, 1986; 41(3): 247 - 250. [Abstract] [PDF]

				C. M. Grondin and R. Limet Sequential Anastomoses in Coronary Artery Grafting: Technical Aspects and Early and Late Angiographic Results Ann. Thorac. Surg., January 1, 1977; 23(1): 1 - 8. [Abstract] [PDF]

				C.-J. Chiu Why Do Radial Artery Grafts for Aortocoronary Bypass Fail? A Reappraisal Ann. Thorac. Surg., December 1, 1976; 22(6): 520 - 523. [Abstract] [PDF]

				N. T. Kouchoukos Coronary Artery Bypass Grafts: How Many?, What Kind? Ann. Thorac. Surg., December 1, 1976; 22(6): 600 - 602. [PDF]