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Ann Thorac Surg 1998;66:1289-1294
© 1998 The Society of Thoracic Surgeons

Original articles: cardiovascular

Angiographic predictors of graft patency and disease progression after coronary artery bypass grafting with arterial and venous grafts

Hannu I. Manninen, MD, PhDa, Pekka Jaakkola, MDb, Matti Suhonen, MDa, Sinikka Rehnberg, MD, PhDc, Rauli Vuorenniemi, MDb, Pekka J. Matsi, MDa

a Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
b Department of Surgery, Kuopio University Hospital, Kuopio, Finland
c Department of Medicine, Kuopio University Hospital, Kuopio, Finland

Accepted for publication May 5, 1998.

Address reprint requests to Dr Manninen, Department of Clinical Radiology, Kuopio University Hospital, SF-70210 Kuopio, Finland

Background. There are few data about angiographic determinants of functional graft patency and native artery disease progression after coronary artery bypass grafting operation with arterial grafts compared with venous grafts.

Methods. Baseline and follow-up coronary angiograms at a mean of 2 years after operation in 91 patients with 194 arterial and 204 venous graft anastomoses were analyzed.

Results. Ninety-two percent of the arterial and 87% of the venous graft anastomoses were patent at follow-up angiography (p = 0.05, odds ratio = 2.63). Unlike that of arterial grafts, the patency rate of venous graft anastomoses correlated negatively with decreasing severity of the bypassed lesion. In contrast to venous grafts, in which angiographic graft function was basically dichotomous (fully patent or occluded), compromised flow of the arterial graft anastomoses was registered in 12%. Progression of the disease was more common in segments bypassed with venous grafts than with arterial grafts (p = 0.001, odds ratio = 2.03).

Conclusions. Angiographic determinants of functional graft patency and progression of occlusive changes in the bypassed artery segments are different for arterial and venous grafts.




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