Key result
Necropsy of 55 patients dying after aortocoronary bypass grafting showed 71% of vein grafts had no appreciable narrowing, while operative technique problems caused 30% of deaths.
Why the study?
What is the state of vein grafts and native coronary arteries, and the principal cause of death in patients dying after aortocoronary bypass grafting?
Observational (n=55)
What is the state of vein grafts and native coronary arteries, and the principal cause of death in patients dying after aortocoronary bypass grafting?
In patients dying after aortocoronary bypass grafting, most vein grafts remain patent, but significant narrowing is common in native arteries distal to anastomoses, and operative technique issues account for nearly a third of deaths.
Answers are grounded in this paper and cite their sources.
Distal narrowing after vein grafting may signal disease progression; leaves open causal role of bypass and needs prospective study.
Fifty five patients with 108 coronary bypass saphenous vein grafts were studied at necropsy. The mean duration of the grafts was 153 days (SD 516). The luminal narrowing of the native coronary arteries proximal to, at, and distal to the vein graft anastomoses and the narrowing of the non-grafted arteries were evaluated planimetrically. Twenty nine per cent of coronary arteries distal to graft anastomoses showed at least 76% narrowing and 50-75% occlusion was seen in 39% of such arteries. Fifty three per cent of non-grafted arteries showed at least 76% luminal narrowing and 26% had 50-75% narrowing. Six patients (11%) had surgically induced dissection of coronary arteries. Seventy seven vein grafts (71%) showed no appreciable luminal narrowing. Problems related to operative technique caused 30% of the deaths.
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Anand Rose (1985) conducted an observational in Death after aortocoronary bypass grafting (n=55). Aortocoronary bypass grafting was evaluated on Luminal narrowing of native coronary arteries and vein grafts, and principal cause of death. Necropsy of 55 patients dying after aortocoronary bypass grafting showed 71% of vein grafts had no appreciable narrowing, while operative technique problems caused 30% of deaths.
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