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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 2001 Febbraio;42(1):9-16
Differences in adaptation to growth of children between internal thoracic artery and saphenous vein coronary bypass grafts
Kameda Y., Kitamura S. *, Taniguchi S., Kawata T., Mizuguchi K., Nishioka H., Sakaguchi H.
From the Department of Surgery III Nara Medical University, Kashihara, Nara, Japan
*Department of Cardiovascular Surgery National Cardiovascular Center, Osaka, Japan
Background. It is not known how the internal thoracic artery (ITA) and saphenous vein graft (SVG) adapts to somatic growth of pediatric patients who underwent coronary artery bypass grafting (CABG).
Methods. Twenty-two ITAs and 6 SVGs in 17 patients who underwent at least three postoperative catheterizations with biplanar cineangiography and followed for a minimum of 5 years were evaluated. We evaluated the length, diameter and curvature of the grafts by cineangiographies which were performed at 1 month, 1 year, 5 years and more than 5 years postoperatively.
Results. The length of the ITA (1-month: 117±31 mm, 1-year: 134±32 mm, 5-years: 146±28 mm, and >5-years: 155±34 mm, p=0.032) and diameter of the ITA (1.4±0.4 mm, 2.0±0.7 mm, 2.3±0.6 mm and 2.6±0.6 mm, p<0.0001) significantly increased over time, but neither the length nor diameter of the SVG length: 121±33 mm, 119±29 mm, 119±25 mm and 126±1 mm, p=0.9907; diameter: 4.1±1.0 mm, 3.9±0.7 mm, 4.0±0.8 mm and 3.3±0.4 mm, p=0.5784) increased. Although the ITA exhibited no change in curvature over time (1 month: 1.15±0.07, late: 1.15±0.07, p=0.8490), the curvature of the SVG significantly decreased over time (1 month: 1.42±0.19 and late: 1.25±0.16, p=0.0277). The percent segmental length of ITAs were changed little from early to late after CABG (1 month: proximal: 33.7±7.0%, middle: 33.3±7.9% and distal: 32.9±7.9%, vs late: 34.3±7.2%, 33.2±7.9% and 32.5±7.9%, p=0.937).
Conclusions. ITAs grow in proportion to somatic growth, while SVGs course in a more linear fashion in adapting to patient growth.