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The Annals of Thoracic Surgery, Vol 30, 336-341, Copyright © 1980 by The Society of Thoracic Surgeons

ARTICLES

Further evaluation of the circular sequential vein graft technique of coronary artery bypass

JC Cleveland, IM Lebenson, RJ Twohey, JG Ellis, DB Nelson, RJ Suchor, AA Heckman Jr, DW Morse and JR Dague

Our study reports a series of circular sequential vein grafts in 21 patients with highly symptomatic triple-vessel coronary artery disease. Four or more distal anastomoses were done in each patient. Thirteen of the patients were restudied, and the results revealed a 97% patency rate for distal anastomoses (58 out of 60) at 4 to 13 months after operation. One patient died 2 months after operation. Postmortem examination revealed a desmoplastic, fibrotic reaction at the proximal anastomosis of the circular graft, with 3 of 4 distal anastomoses patent. Twenty of the 21 patients in this series are now alive with asymptomatic cardiac status 14 to 22 months after operation. The finding by Grondin and associates [1] of increased patency rate with this technique for distal anastomoses is confirmed. The circular sequential vein graft represents a particularly advantageous technique for patients in whom 4 to 6 distal anastomoses are needed for complete revascularization and in whom one or more vessels have limited runoff. The obvious disadvantage of this technique is that all distal anastomoses depend on a single proximal anastomosis.




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Copyright © 1980 by The Society of Thoracic Surgeons.