Mid-Term Clinical Outcome of Patients Undergoing Coronary Artery Bypass Grafting with Valvulotomized Vein Grafts

  • Selcuk Anli Department of Thoracic and Cardiovascular Surgery, University Hospital, Frankfurt/Main, Germany.
  • Afsaneh Karimian-Tabrizi Department of Thoracic and Cardiovascular Surgery, University Hospital, Frankfurt/Main, Germany.
  • Anton Moritz Department of Thoracic and Cardiovascular Surgery, University Hospital, Frankfurt/Main, Germany.
  • Nadejda Monsefi Department of Cardiothoracic Surgery, Heart Center Siegburg, Siegburg, Germany.
Keywords: valvulotomized vein grafts, bypass graft patency

Abstract

Background: The lower patency rate of vein grafts (VG) in comparison to arterial grafts may be related to vein valves, which favor turbulences and thrombosis that lead to graft failure. The aim of this study was to determine the outcome of patients with valvulotomized VG after coronary artery bypass grafting (CABG) procedure. 

Methods: From 2007 to 2014, 233 patients with a mean age of 67 ± 9 years had CABG or combined CABG and valve procedures. Valvulotomized saphenous VG and arterial grafts were used. Clinical follow-up and outcome were evaluated after 6.3 ± 2 years. The graft patency was rated with multislice computed tomography in 57 patients and coronary angiography in 29 patients 3.1 ± 2 years postoperatively.

Results: Overall, 168 patients had segregated CABG surgery, and 65 patients received additional procedures, with mean 2.7 ± 1 arterial and 1.5 ± 0.7 venous anastomoses. The 30-day-mortality in isolated CABG patients was 2%. Survival at five years was 80%. Major adverse cardiac and cerebrovascular events (MACCE) free rate at five years was 80%. At the last follow up (mean 6.3 years), 94% of the patients were in Canadian Cardiovascular Society (CCS) class 0. The quote of patent valvulotomized VG was 96.1% compared to a patency rate of 96.7% for the arterial grafts in the subgroup undergoing angiography or computed tomography of the heart. 

Conclusion: Our data demonstrate good mid-term results of graft patency, and comparable clinical results in patients undergoing CABG with valvulotomized VG. A longer follow-up period and a higher number of bypass graft imaging examinations are necessary to affirm our results.

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Published
2018-06-18
Section
Articles