Mid-to Long-term Outcomes of Different Grafts for Selective Coronary Venous Bypass Grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGFan , YUYang , LIJing-xing , LIHai-tao , GAOMing-xin , DAILong-sheng , BAIChen , WANGJia-yang ,  GUCheng-xiong

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding author：

GUCheng-xiong, Email: anzhengu@sina.com

Keywords：

Diffuse right coronary artery atherosclerosis; Selective coronary venous bypass grafting; Middle cardiac vein; Mid-to long-term outcome

DOI：

10.7507/1007-4848.20150063

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Objective To compare mid-to long-term outcomes of selective coronary venous bypass grafting (SCVBG) using internal mammary artery (IMA) grafts and great saphenous vein (GSV) grafts for surgical treatment of diffuse right coronary artery atherosclerosis. Methods We retrospectively analyzed clinical data of 75 patients undergoing SCVBG in Beijing Anzhen Hospital from January 2003 to December 2012. GSV was used as grafts for SCVBG in 54 patients (GSV group), and IMA was used as grafts for SCVBG in 21 patients (IMA group). All the patients were followed up in November 2013. Their survival condition, recent relapse rate of angina, recent echocardiographic results and coronary CT angiography (CTA) were analyzed. Results Overall survival rate of IMA group was slightly higher than that of GSV group (100.0% vs. 83.3%), but survival curves showed no statistical difference in survival rate between the 2 groups (P=0.055). Coronary CTA showed significant blockage in GSV grafts and middle cardiac vein in patients in GSV group (n=39), while IMA grafts and middle cardiac vein in patients in IMA group (n=18) were mostly visible and patent (P < 0.001). Left ventricular ejection fraction (LVEF) of the 2 groups were significantly higher than preoperative values, but there was no statistical difference between the 2 groups. Conclusion Compared with SCVBG using GSV, SCVBG using IMA can significantly improve mid-to long-term patency of the grafts and middle cardiac vein, and is an efficacious procedure for diffuse right coronary artery atherosclerosis.

Citation： ZHANGFan, YUYang, LIJing-xing, LIHai-tao, GAOMing-xin, DAILong-sheng, BAIChen, WANGJia-yang, GUCheng-xiong. Mid-to Long-term Outcomes of Different Grafts for Selective Coronary Venous Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 225-229. doi: 10.7507/1007-4848.20150063 Copy

1.	de la Cruz KI, Tsai PI, Cohn WE, et al.Revascularization treatment recommendations based on atherosclerotic disease distribution:coronary artery bypass grafting versus stenting.Curr Atheroscler Rep, 2008, 10(5):434-437.
2.	Hochberg MS, Roberts WC, Morrow AG, et al.Selective arterialization of the coronary venous system.Encouraging long-term flow evaluation utilizing radioactive microspheres.J Thorac Cardiovasc Surg, 1979, 77(1):1-12.
3.	Rhodes GR, Syracuse DC, Mcintosh CL.Evaluation of regional myocardial nutrient perfusion following selective retrograde arterialization of the coronary vein.Ann Thorac Surg, 1978, 25(4):329-335.
4.	刘锐, 顾承雄, 韦华, 等.部分冠状静脉动脉化在不停跳冠状动脉旁路移植术中的应用.中华胸心血管外科杂志, 2004, 20(4):247.
5.	于洋, 顾承雄, 韦华, 等.非体外循环下双乳内动脉序贯旁路移植并行SCVBG5例.中华胸心血管外科杂志, 2008, 24(2):123-124.
6.	Yu Y, Yan XL, Wei H, et al.Off-pump sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system.Chin Med, 2011, 124(19):3017-3021.
7.	于洋, 顾承雄, 李海涛.非体外循环双乳内动脉序贯旁路移植加选择性心中静脉动脉化手术的疗效分析.中国胸心血管外科临床杂志, 2011, 18(5):394-398.
8.	Tabata M, Shekar PS, Couper GS, et al.Early and late outcomes of multiple coronary endarterectomy.J Card Surg, 2008, 23(6):697-700.
9.	Urban M, Pirk J, Szárszoi O, et al.Transmyocardial laser revascularization.Rozhl Chir, 2009, 88(9):489-492.
10.	Briones E, Lacalle JR, Marin I.Transmyocardial laser revasculariza tion versus medical therapy for refractory angina.Cochrane Data base Syst Rev, 2009, 21(1):CD003712.
11.	Ahn A, Frishman WH, Gutwein A, et al.Therapeutic angiogenesis a new treatment approach for ischemic heart disease-part I.Cardiol Rev, 2008, 16(4):163-171.
12.	Chowdhry MF, Davies J, Mccance A, et al.Lack of durability of surgical arterialization of coronary veins for the treatment of ischemic heart disease.J Card Surg, 2005, 20(4):326-328.
13.	Sabik JF 3rd, Lytle BW, Blackstone EH, et al.Comparison of saphenous vein and internal thoracic artery graft patency by coronary system.Ann Thorac Surg, 2005, 79(2):544-551.
14.	Gansera B, Schmidtler F, Angelis I, et al.Patency of internal thoracic artery compared to vein grafts-postoperative angiographic findings in 1189 symptomatic patients in 12 years.Thorac Cardiovasc Surg, 2007, 55(7):412-417.
15.	Muto A, Model L, Ziegler K, et al.Mechanisms of vein graft adaptation to the arterial circulation:Insights into the neointimal algorithm and managementstrategies.Circ J, 2010, 74(8):1501-1512.
16.	Owens CD.Adaptive changes in autogenous vein grafts for arterial reconstruction:clinical implications.J Vasc Surg, 2010, 51(3):736-746.
17.	Kassab GS, Navia JA, March K, et al.Coronary venous retroperfu sion:an old concept, a new approach.J Appl Physiol, 2008, 104(5):1266-1272.
18.	Sisto T, Ylä-Herttuala S, luoma J, et al.Biochemical composition of human internal mammary artery and saphenous vein.J Vasc Surg, 1990, 11(3):418-422.
19.	Aydin S, Aydin S, Nesimi EM, et al.The cardiovascular system and the biochemistry of grafts used in heart surgery.Springerplus, 2013, 16(2):612-617.
20.	Toprak V, Sirin BH, Tok D, et al.The effect of cardiopulmonary bypass on the expression of inducible nitric oxide synthase, endothelial nitric oxide synthase, and vascular endothelial growth factor in the internal mammary artery.J Cardiothorac Vasc Anesth, 2006, 20(1):63-67.
21.	Bonatti J, Dichtl W, Dworzak EA, et al.Atrial natriuretic peptide-induced release of cyclic guanosine monophosphate by coronary bypass grafts.Ann Thorac Surg, 1998, 65(6):1621-1624.

1. de la Cruz KI, Tsai PI, Cohn WE, et al.Revascularization treatment recommendations based on atherosclerotic disease distribution:coronary artery bypass grafting versus stenting.Curr Atheroscler Rep, 2008, 10(5):434-437.
2. Hochberg MS, Roberts WC, Morrow AG, et al.Selective arterialization of the coronary venous system.Encouraging long-term flow evaluation utilizing radioactive microspheres.J Thorac Cardiovasc Surg, 1979, 77(1):1-12.
3. Rhodes GR, Syracuse DC, Mcintosh CL.Evaluation of regional myocardial nutrient perfusion following selective retrograde arterialization of the coronary vein.Ann Thorac Surg, 1978, 25(4):329-335.
4. 刘锐, 顾承雄, 韦华, 等.部分冠状静脉动脉化在不停跳冠状动脉旁路移植术中的应用.中华胸心血管外科杂志, 2004, 20(4):247.
5. 于洋, 顾承雄, 韦华, 等.非体外循环下双乳内动脉序贯旁路移植并行SCVBG5例.中华胸心血管外科杂志, 2008, 24(2):123-124.
6. Yu Y, Yan XL, Wei H, et al.Off-pump sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system.Chin Med, 2011, 124(19):3017-3021.
7. 于洋, 顾承雄, 李海涛.非体外循环双乳内动脉序贯旁路移植加选择性心中静脉动脉化手术的疗效分析.中国胸心血管外科临床杂志, 2011, 18(5):394-398.
8. Tabata M, Shekar PS, Couper GS, et al.Early and late outcomes of multiple coronary endarterectomy.J Card Surg, 2008, 23(6):697-700.
9. Urban M, Pirk J, Szárszoi O, et al.Transmyocardial laser revascularization.Rozhl Chir, 2009, 88(9):489-492.
10. Briones E, Lacalle JR, Marin I.Transmyocardial laser revasculariza tion versus medical therapy for refractory angina.Cochrane Data base Syst Rev, 2009, 21(1):CD003712.
11. Ahn A, Frishman WH, Gutwein A, et al.Therapeutic angiogenesis a new treatment approach for ischemic heart disease-part I.Cardiol Rev, 2008, 16(4):163-171.
12. Chowdhry MF, Davies J, Mccance A, et al.Lack of durability of surgical arterialization of coronary veins for the treatment of ischemic heart disease.J Card Surg, 2005, 20(4):326-328.
13. Sabik JF 3rd, Lytle BW, Blackstone EH, et al.Comparison of saphenous vein and internal thoracic artery graft patency by coronary system.Ann Thorac Surg, 2005, 79(2):544-551.
14. Gansera B, Schmidtler F, Angelis I, et al.Patency of internal thoracic artery compared to vein grafts-postoperative angiographic findings in 1189 symptomatic patients in 12 years.Thorac Cardiovasc Surg, 2007, 55(7):412-417.
15. Muto A, Model L, Ziegler K, et al.Mechanisms of vein graft adaptation to the arterial circulation:Insights into the neointimal algorithm and managementstrategies.Circ J, 2010, 74(8):1501-1512.
16. Owens CD.Adaptive changes in autogenous vein grafts for arterial reconstruction:clinical implications.J Vasc Surg, 2010, 51(3):736-746.
17. Kassab GS, Navia JA, March K, et al.Coronary venous retroperfu sion:an old concept, a new approach.J Appl Physiol, 2008, 104(5):1266-1272.
18. Sisto T, Ylä-Herttuala S, luoma J, et al.Biochemical composition of human internal mammary artery and saphenous vein.J Vasc Surg, 1990, 11(3):418-422.
19. Aydin S, Aydin S, Nesimi EM, et al.The cardiovascular system and the biochemistry of grafts used in heart surgery.Springerplus, 2013, 16(2):612-617.
20. Toprak V, Sirin BH, Tok D, et al.The effect of cardiopulmonary bypass on the expression of inducible nitric oxide synthase, endothelial nitric oxide synthase, and vascular endothelial growth factor in the internal mammary artery.J Cardiothorac Vasc Anesth, 2006, 20(1):63-67.
21. Bonatti J, Dichtl W, Dworzak EA, et al.Atrial natriuretic peptide-induced release of cyclic guanosine monophosphate by coronary bypass grafts.Ann Thorac Surg, 1998, 65(6):1621-1624.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Mid-to Long-term Outcomes of Different Grafts for Selective Coronary Venous Bypass Grafting

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