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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2001 February;42(1):9-16

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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.

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