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Critical analysis of the preoperative and operative predictors of aortocoronary bypass patency.

Authors
  • Crosby, I K
  • Wellons, H A Jr
  • Taylor, G J
  • Maffeo, C J
  • Beller, G A
  • Muller, W H Jr
Type
Published Article
Journal
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Jun 01, 1981
Volume
193
Issue
6
Pages
743–751
Identifiers
PMID: 6972745
Source
Medline
License
Unknown

Abstract

A prospective analysis of the angiographic and operative anatomic and reconstructive variables that influenced graft patency was undertaken at the University of Virginia Medical Center in 50 consecutive patients. Postoperative restudy showed that 18 of the 168 grafts performed were occluded due to venous disease, inadequate run-off, or sequential design error. Angiographic artery size was 27% larger than operative estimations; graft patency significantly increased with increasing distal artery diameter, with decreasing venous conduit diameter, and with good graftability rating of the vessels preoperatively. Ejection fraction, the degree of arterial stenosis, and the source of the saphenous vein conduit (the thigh or the lower leg) had no influence on graft patency. Simple grafts had a 96% patency, while sequential grafts had an 80% patency. When design error for sequential grafts was eliminated, the sequential patency rate rose to 88%. For revascularization of small circumflex vessels, consideration should be given to variation in the sequential grafting technique to improve patency in these vessels.

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