These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Survival and graft patency after coronary artery bypass grafting with coronary endarterectomy: role of arterial versus vein conduits.
    Author: Schwann TA, Zacharias A, Riordan CJ, Durham SJ, Shah AS, Habib RH.
    Journal: Ann Thorac Surg; 2007 Jul; 84(1):25-31. PubMed ID: 17588376.
    Abstract:
    BACKGROUND: Coronary artery bypass grafting with concomitant coronary endarterectomy (CABG/CE) is used in patients with severe coronary atherosclerosis to revascularize otherwise ungraftable targets. This study investigates the efficacy of arterial versus vein grafting for CABG/CE surgery. METHODS: We reviewed our experience in 288 CABG/CE patients (63 +/- 10 years, 207 men). A total of 1,056 grafts (275 internal thoracic artery [ITA] [26%]; 221 radial [21%], 560 vein [53%]) were constructed including 325 (31%) placed to CE targets. RESULTS: Eighteen of 288 patients died in-hospital (6.3%). Unadjusted one-year and five-year survival for the 270 discharged patients was 95.2% and 83.0%, respectively. Survival (0 to 7 years) was significantly better for patients with radial (n = 154) versus no-radial (n = 134) artery grafting (p = 0.021). Multivariate Cox regression analysis associated increased number of arterial grafts (hazard ratio [HR] = 0.64 [0.44 to 0.92]; HR [95% confidence interval]) to improved survival, while RCA endarterectomy (HR = 1.8 1.0 3.3; p = 0.054) was associated with worse survival. Repeat angiography (495 days [median]) in 68 patients encompassed 78 CE (38 vein, 24 ITA, and 16 radial) and 162 non-CE (84 vein, 40 ITA, and 38 radial) grafts. Graft failure was similar (p = 0.37) for radial (10 of 54 [19%]) and ITA (7 of 64 [11%]), and worst for vein (50 of 122 [41%]; p < 0.001). For CE targets, graft failure was worse for vein (55% vs 35%; p = 0.05) and unchanged for arterial (13% vs 15%; p = 0.88) grafts. CONCLUSIONS: Combined CABG/CE is associated with good long-term outcomes. Increased arterial grafting achieved by radial artery utilization confers a survival benefit in this high-risk population. The latter is probably derived from superior radial versus vein graft patency.
    [Abstract] [Full Text] [Related] [New Search]