Abstract 15289: Long-Term Results of Sequential Vein Aortocoronary Bypass Grafting Compared to Totally Arterial Myocardial Revascularization
Objective: to analyze the early and long-term outcome of a consecutive series of patient operated of sequential saphenous vein CABG, and to compare to a matched population of totally arterial revascularized patients.
Methods: From January 1994 to December 1996, 240 patients underwent totally arterial myocardial revascularization(bilateral ITA plus radial artery or right gastroepiploic artery) at our Institution (ARTGroup). In the same period 2097 patients underwent CABG with left ITA-on-LAD and great saphenous vein on the right and circumflex branches sequentially(SVGroup). A propensity score was used to obtain risk-adjusted outcome comparisons between the two groups.
Results: 30-days mortality was 1% in ART group and 0.4% in SV group(p=0.886). Mean follow-up was 13.8±3.6 years. Long-term survival was comparable among the two study groups [actuarial 5-and 15-years survival rates were 97% vs 93% and 82% vs 79% in ART group and SV group respectively(p=0.299)]. At follow-up, recurrence of angina(17% vs 18%; p=0.992), acute MI(3% vs 5%;p=0.725) and repeated PCI (19% vs 21%;p=0.697) were similar in both groups. At the Cox regression analysis type of revascularization was not an independent predictor of any long-term outcomes(death or MACE). In asymptomatic patients exercise stress test at FU (functional capacity, ergometric parameters and ECG alterations) was comparable between the two groups(p=0.14).
Conclusions: Sequential vein CABG showed a promising early and long-term outcomes. Completeness of revascularization, low resistance of the sequentially grafted coronaries and higher flow into the venous graft could be the determinant of such promising clinical results.
- © 2012 by American Heart Association, Inc.