Long-term results of myocardial revascularization by direct and sequential venous grafts in multiple-vessel coronary artery disease

Objective. To analyze direct and sequential venous conduits in long-term period after coronary artery bypass surgery. Material and methods. We analyzed coronary angiography data in 258 patients operated on between 2015 and 2020. Inclusion criterion was coronary artery bypass grafting with direct or sequential venous conduits excluding left anterior descending artery. We assessed 505 direct and 124 sequential grafts. The long-term results of coronary artery bypass surgery and major anatomical and topographic coronary factors influencing functional viability of venous conduits were analyzed. Results. Satisfactory function of conduits regardless the type of the graft was observed in 79.3% of cases, dysfunction — in 3.1% of cases, occlusion — in 17.6% of cases. Functional viability of direct grafts was significantly lower compared to sequential grafts (78.4 vs. 83.1%, p<0.05). Sequential conduits are more preferable for coronary arteries >1.5 mm and ≤1.5 mm (88.5 vs. 82.0% (for arteries >1.5 mm) and 76.6 vs. 63.2% (for arteries ≤1.5 mm), p<0.05). Function of different conduits does not depend on coronary artery pool. Conclusion. Sequential anastomoses are preferred for revascularization of arteries <1.5 mm. One should consider that state of bypassed coronary artery determines patency of the conduit.