Do the Paths of Sequential Vein Grafts Influence the Outcomes of Coronary Artery Bypass Surgeries?

  • Yuan-Hsi Tseng Chia-Yi Chang Gung Memorial Hospital
  • Chih-Chen Kao
  • Chien-Chao Lin
  • Chien-Wei Chen
  • Ming-Shian Lu
  • Chu-Hsueh Lu
  • Yao-Kuang Huang
Keywords: coronary artery bypass grafting;, coronary artery bypass surgery;, sequential vein graft;, great saphenous vein graft

Abstract

Background: The use of a sequential vein graft (SVG) in coronary artery bypass grafting (CABG) in multi-vessel coronary disease is common. This study aimed to investigate the influence of the paths of SVGs on the outcomes of CABG.

Methods: From January 2011 to June 2017, 126 patients underwent elective isolated CABG. If the path of the SVG was from the aorta to the right coronary artery (RCA)/ posterior descending artery (PDA) to the left circumflex artery (LCX)/obtuse marginal artery (OM), the patients were included in Group R. If the path was from the aorta to the LCX/OM to the RCA/PDA, the patients were included in Group L. The in-hospital and follow-up outcomes were analyzed.

Results: Group R had 69 patients, and Group L had 57 patients. Univariate analysis showed that Group L had a higher number of grafts (P < .001) and less aortic cross-clamping time (P < .001) and total bypass time (P = .001). Otherwise, Group L had 14 patients (19.3%), who received first diagonal branch (D1) bypass grafting, while Group R had none (P < .001). In the multivariate analysis, in-
hospital mortality from heart failure, postoperative acute kidney injury, medium-term mortality, and readmission for cardiac incidents were not associated with the SVG path.

Conclusion: The SVG path from the aorta to the LCX/OM to the RCA/PDA facilitated the additional D1 bypass grafting, but the outcomes for this approach were not significantly different from those for the other path.

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Published
2020-01-23
How to Cite
Tseng, Y.-H., Kao, C.-C., Lin, C.-C., Chen, C.-W., Lu, M.-S., Lu, C.-H., & Huang, Y.-K. (2020). Do the Paths of Sequential Vein Grafts Influence the Outcomes of Coronary Artery Bypass Surgeries?. The Heart Surgery Forum, 23(1), E001-E006. https://doi.org/10.1532/hsf.2729
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Articles