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Ann Thorac Surg 1999;67:1240-1244
© 1999 The Society of Thoracic Surgeons

Original Articles

Coronary artery bypass grafting with an expanded polytetrafluoroethylene graft

Michael Weyand, MDa, Sebastian Kerber, MDc, Christof Schmid, MDa, Norbert Rolf, MDb, Hans H. Scheld, MDa

a Department of Cardiothoracic Surgery, Westfalian Wilhelms University, Muenster, Germany
b Department of Anesthesiology and Intensive Care Medicine, Westfalian Wilhelms University, Muenster, Germany
c Department of Cardiology and Angiology, Westfalian Wilhelms University, Muenster, Germany

Accepted for publication September 18, 1998.

Address reprint requests to Dr Weyand, Department of Cardiothoracic Surgery, University of Muenster, Albert Schweitzer Str 33, 48129 Muenster, Germany
e-mail: mweyand{at}uni-muenster.de

Background. We report our experience with the Perma-Flow aortocoronary–right heart graft in 15 patients in whom autologous conduits were not available.

Methods. Fifteen patients received 39 coronary anastomoses—10 to left anterior descending coronary artery branches, 15 to circumflex coronary artery branches, and 14 to branches of the right coronary artery. Early angiography was done in 11 patients.

Results. One patient died on postoperative day 17 of multiorgan failure. The graft was patent at postmortem examination. Of 30 coronary anastomoses at risk, 24 were patent. Three connections to the left anterior descending system were occluded in patients with an additional internal mammary artery graft to the same coronary system, and three connections to the circumflex system were occluded in patients with a history of major posterior infarction. Three of five distal anastomoses to the right atrial appendage were occluded, whereas all six connections to the superior vena cava were patent. None of the patients had shown recurrent angina at a mean follow-up of 10.9 months (range, 2–39 months).

Conclusions. The synthetic Perma-Flow coronary graft appears to be a safe alternative in patients in whom arterial or venous conduits are not available. Competitive flow may lead to anastomotic occlusions. The appropriate site for the distal arteriovenous fistula seems to be the superior vena cava.


Related Article

Robert W. Emery
Ann. Thorac. Surg. 1999 67: 1244-1245. [Extract] [Full Text] [PDF]





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