S-Space College of Medicine/School of Medicine (의과대학/대학원) Thoracic Surgery (흉부외과학전공) Journal Papers (저널논문_흉부외과학전공)
Midterm angiographic follow-up after off-pump coronary artery bypass: serial comparison using early, 1-year, and 5-year postoperative angiograms
- Kim, Ki-Bong; Cho, Kwang Ree; Jeong, Dong Seop
- Issue Date
- J Thorac Cardiovasc Surg. 2008 Feb;135(2):300-7.
- Aged; Analysis of Variance; Coronary Angiography/*methods; Coronary Artery Bypass, Off-Pump/*methods; Coronary Restenosis/*radiography; Coronary Stenosis/mortality/*radiography/*surgery; Female; Follow-Up Studies; Graft Rejection; Graft Survival; Humans; Male; Middle Aged; Postoperative Complications/mortality/radiography; Probability; Retrospective Studies; Survival Rate; Time Factors; Vascular Patency
- OBJECTIVE: We analyzed the angiographic changes of the anastomotic sites at three time points for 5 years after off-pump coronary artery bypass surgery. METHODS: Of the 402 patients who underwent off-pump coronary artery bypass surgery between January 1998 and December 2001, 240 patients who received the early, 1-year, and 5-year follow-up coronary angiograms regardless of the patient's anginal symptoms were studied. Morphologic changes of grafts were traced by the FitzGibbon grading system. RESULTS: Overall graft patency rates (FitzGibbon grade A+B) at early, 1-year, and 5-year angiography were 98.6%, 91.9%, and 88.3%, respectively. Graft patency rates in the left anterior descending artery, left circumflex artery, and right coronary artery territories were similar at early angiograms (P = .162). However, graft patency rate in the left anterior descending artery territory was higher than that in the left circumflex artery and right coronary artery territories at both the 1-year (P < .001) and 5-year (P < .001) angiograms. Of the 31 FitzGibbon grade B arterial grafts (internal thoracic artery and right gastroepiploic artery) at early angiography, 10 became occluded and 19 became grade A at 5-year angiography. In the saphenous vein grafts, grade B lesions gradually increased during the 5 postoperative years (2.6% vs 6.5% vs 13.3%). CONCLUSIONS: Midterm angiographic follow-up demonstrated acceptable patency rates of grafts after off-pump coronary artery bypass surgery. Approximately half of the FitzGibbon grade B arterial grafts in the early angiograms became grade A at 5 years after surgery, but the proportion of grade B saphenous vein grafts gradually increased over the 5 postoperative years.
- 1097-685X (Electronic)