Circulation, Vol 90, 2367-2374, Copyright © 1994 by American Heart Association
J van der Meer, HL Hillege, WH van Gilst, A Brutel de la Riviere, PH Dunselman, V Fidler, GJ Kootstra, BJ Mulder, M Pfisterer and KI Lie
BACKGROUND--Superior patency rates for internal mammary artery (IMA) grafts
compared with vein coronary bypass grafts have been demonstrated by
retrospective studies. This difference may have been affected by selection
bias of patients and coronary arteries for IMA grafting. METHODS AND
RESULTS--To estimate the difference between IMA and vein grafts, we
analyzed graft patency data of 912 patients who entered a randomized
clinical drug trial. In this trial, 494 patients received both IMA and vein
grafts (group 1) and 418 only vein grafts (group 2). Occlusion rates of IMA
grafts and IMA plus vein grafts in group 1 were compared with those of vein
grafts in group 2. Multivariate analysis was used to compare occlusion
rates of IMA and vein grafts while other variables related to graft patency
were controlled for. In addition, 1- year clinical outcome was assessed by
the incidence of myocardial infarction, thrombosis, major bleeding, and
death. Occlusion rates of distal anastomoses in group 1 versus group 2 were
5.4% (IMA grafts) versus 12.7% (vein grafts) (P < .0001) and 10.4% (IMA
plus vein grafts) versus 12.7% (vein grafts) (P = .14). There was no
difference in adjusted risk of occlusion between IMA grafts and vein grafts
(P = .089). Type and location of distal anastomosis and lumen diameter of
the grafted coronary artery were shown to be predictors of occlusion.
Clinical events occurred in 17.8% (group 1) and 16.0% (group 2) of patients
(P = .53). CONCLUSIONS--The observed difference in 1-year occlusion rates
between IMA and vein grafts can be explained by a maldistribution of graft
characteristics by selection of coronary arteries for IMA grafting rather
than being ascribed to graft material. One-year clinical outcome is not
improved by IMA grafting.
ARTICLES
A comparison of internal mammary artery and saphenous vein grafts after coronary artery bypass surgery. No difference in 1-year occlusion rates and clinical outcome. CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands
Department of Cardiology, University Hospital Groningen, The Netherlands.
This article has been cited by other articles:
 |
|
 |
|
  B. Marcheix, F. Vanden Eynden, P. Demers, D. Bouchard, and R. Cartier Influence of Diabetes Mellitus on Long-Term Survival in Systematic Off-Pump Coronary Artery Bypass Surgery Ann. Thorac. Surg., October 1, 2008; 86(4): 1181 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. K. Singh, N. D. Desai, S. D. Petroff, S. Deb, E. A. Cohen, S. Radhakrishnan, L. Schwartz, J. Dubbin, S. E. Fremes, and for the Radial Artery Patency Study Investigators The Impact of Diabetic Status on Coronary Artery Bypass Graft Patency: Insights From the Radial Artery Patency Study Circulation, September 30, 2008; 118(14_suppl_1): S222 - S225. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Becker, T. W. Meade, P. B. Berger, M. Ezekowitz, C. M. O'Connor, D. A. Vorchheimer, G. H. Guyatt, D. B. Mark, and R. A. Harrington The Primary and Secondary Prevention of Coronary Artery Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 776S - 814S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. R. Cho, D. S. Jeong, and K.-B. Kim Influence of vein graft use on postoperative 1-year results after off-pump coronary artery bypass surgery Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 718 - 723. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. R. Cho, J.-S. Kim, J.-S. Choi, and K.-B. Kim Serial angiographic follow-up of grafts one year and five years after coronary artery bypass surgery. Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 511 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gossl and A. Lerman Endothelin: Beyond a Vasoconstrictor Circulation, March 7, 2006; 113(9): 1156 - 1158. [Full Text] [PDF]
|
|
|
|
|
|
J.-S. Choi, K. R. Cho, and K.-B. Kim Does Diabetes Affect the Postoperative Outcomes After Total Arterial Off-Pump Coronary Bypass Surgery in Multivessel Disease? Ann. Thorac. Surg., October 1, 2005; 80(4): 1353 - 1360. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.-E. Falcoz, S. Chocron, C. Binquet, L. Stoica, D. Kaili, C. Quantin, and J.-P. Etievent Revascularization of the Right Coronary Artery: Grafting or Percutaneous Coronary Intervention? Ann. Thorac. Surg., April 1, 2005; 79(4): 1232 - 1239. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Widimsky, Z. Straka, P. Stros, K. Jirasek, J. Dvorak, J. Votava, L. Lisa, T. Budesinsky, M. Kolesar, T. Vanek, et al. One-Year Coronary Bypass Graft Patency: A Randomized Comparison Between Off-Pump and On-Pump Surgery Angiographic Results of the PRAGUE-4 Trial Circulation, November 30, 2004; 110(22): 3418 - 3423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Stein, H. J. Schunemann, J. E. Dalen, and D. Gutterman Antithrombotic Therapy in Patients With Saphenous Vein and Internal Mammary Artery Bypass Grafts: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest, September 1, 2004; 126(3_suppl): 600S - 608S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Schwartz, K. E. Kip, R. L. Frye, E. L. Alderman, H. V. Schaff, and K. M. Detre Coronary Bypass Graft Patency in Patients With Diabetes in the Bypass Angioplasty Revascularization Investigation (BARI) Circulation, November 19, 2002; 106(21): 2652 - 2658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-B. Kim, C. Lim, C. Lee, I.-H. Chae, B.-H. Oh, M.-M. Lee, and Y.-B. Park Off-pump coronary artery bypass may decrease the patency of saphenous vein grafts Ann. Thorac. Surg., September 1, 2001; 72(3): S1033 - 1037. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Stein, J. E. Dalen, S. Goldman, and P. Theroux Antithrombotic Therapy in Patients With Saphenous Vein and Internal Mammary Artery Bypass Grafts Chest, January 1, 2001; 119 (2009): 278S - 282S. [Full Text] [PDF]
|
|
|
|
|
|
M. Verstraete, C. R. M. Prentice, M. Samama, and R. Verhaeghe A European View on the North American Fifth Consensus on Antithrombotic Therapy Chest, June 1, 2000; 117(6): 1755 - 1770. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. A.G. Louagie, C. E. Brockmann, J. Jamart, E. Schroeder, M. Buche, P. M. Eucher, and J.-C. Schoevaerdts Pulsed Doppler intraoperative flow assessment and midterm coronary graft patency Ann. Thorac. Surg., October 1, 1998; 66(4): 1282 - 1287. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. I. Manninen, P. Jaakkola, M. Suhonen, S. Rehnberg, R. Vuorenniemi, and P. J. Matsi Angiographic predictors of graft patency and disease progression after coronary artery bypass grafting with arterial and venous grafts Ann. Thorac. Surg., October 1, 1998; 66(4): 1289 - 1294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Watarida, S. Shiraishi, K. Katsuyama, Y. Nakajima, and A. Mori Reverse Redistribution Phenomenon After CABG: Differences Between ITA and SV Grafts Ann. Thorac. Surg., December 1, 1997; 64 (6): 1876 - 1877. [Full Text]
|
|
|
|
 |
|
 B. P. Bidstrup Coronary Artery Bypass Graft Patency Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 1997; 1(4): 282 - 287. [Abstract] [PDF]
|
|
|
|
|
|
G. Campalani, T. A. Salerno, J. Bergsland, and A. M. Calafiore Minimally Invasive Coronary Artery Bypass Grafting Ann. Thorac. Surg., July 1, 1997; 64 (1): 285 - 286. [Full Text]
|
|