Key result
The presence of two venous valves in a saphenous vein graft caused flow disturbance and subsequent graft failure (occlusion, thrombus, or atherosclerosis) in 5 patients.
Why the study?
Does the presence of more than one venous valve in a saphenous vein graft cause flow disturbance and graft failure in post-CABG patients?
Case Report (n=5)
Does the presence of more than one venous valve in a saphenous vein graft cause flow disturbance and graft failure in post-CABG patients?
The presence of multiple venous valves in saphenous vein grafts may cause flow disturbances that predispose to graft failure, highlighting the importance of flow velocity for graft integrity.
Answers are grounded in this paper and cite their sources.
Multiple venous valves may predispose to SVG failure; hypothesis-generating in 5 cases and leaves open whether valve-sparing harvest affects patency.
Late (greater than 1 year) postoperative angiographic studies in five patients revealed evidence of flow disturbance at the distal valve, when two valves were present in the body of a saphenous vein graft (SVG). This was associated with delayed clearance of radiopaque dye due to reduced velocity of flow. On follow-up, occlusion, thrombus formation, or development of atherosclerosis seemed to have occurred in anatomic relation to these valves. All five patients had one additional graft in a good state of preservation; three internal mammary artery (IMA) grafts, and 2 SVGs. The latter had only one venous valve, and the velocity of flow was good. It appears that good velocity of flow is essential to the integrity of coronary bypass grafts. The presence of more than one venous valve in a graft appears to cause flow disturbance and sluggish velocity, factors adversely affecting their integrity.
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Ram N. Singh (1986) conducted a case report in Coronary bypass grafts (n=5). Presence of two venous valves in a saphenous vein graft vs. Grafts with only one venous valve or internal mammary artery grafts was evaluated on Flow disturbance and graft integrity (occlusion, thrombus formation, or atherosclerosis). The presence of two venous valves in a saphenous vein graft caused flow disturbance and subsequent graft failure (occlusion, thrombus, or atherosclerosis) in 5 patients.
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