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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2013 August;54(4):531-6

lingua: Inglese

Mammary artery to saphenous vein composite T grafts for coronary artery bypass: late follow-up

Mayorchak Y. 1, Paterson HS. 2, Ryan J. B. 1, Byth K. 3, Robinson L. M. 1, Kovoor P. 1, Denniss A. R. 1

1 Department of Cardiovascular Services Westmead Hospital, Sydney, New Soth Wales, Australia;
2 Department of Surgery, University of Sydney Sydney, Australia;
3 Westmead Millenium Institute, Westmead New south Wales, Australia


Aim: Composite arterial grafts using a T configuration from the left internal mammary artery (LIMA) are commonly used for coronary artery surgery. Little data exist regarding the use of saphenous vein (SV) in composite grafts from the LIMA. This study aimed to determine whether LIMA patency was reduced by the attachment of a SV T graft.
Methods: Patients (N.=166) who underwent coronary bypass surgery using the LIMA for SV graft inflow were identified from a database. Post discharge angiography was performed for investigation of symptoms or evidence of myocardial ischemia. Follow-up identified episodes of angiography, re-intervention and death.
Results: Complete follow-up was obtained in 165 patients, mean 6 years (0-16 years). The mean patient age was 70 years and 43 patients underwent concomitant procedures. In 25 patients who underwent post discharge angiography, the LIMA and T anastomoses were widely patent in 14 patients. The SV graft was occluded at the T anastomosis in 8 patients and the distal limb of the LIMA was occluded in 2 patients. In no patients were the vein and LIMA both occluded.
Conclusion: The use of the LIMA for SV graft inflow does not appear to compromise the LIMA graft even when SV graft occlusion occurs.

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