Key result
Isolated SVBG to the LAD yields ~77% freedom from graft failure events at 10 years.
Why the study?
To establish a benchmark for the clinical efficacy of PTCA and the internal mammary artery graft by analyzing outcomes of isolated saphenous vein bypass grafts to the LAD.
What are the long-term clinical outcomes of isolated saphenous vein bypass grafts to the left anterior descending artery?
Cohort (n=79)
No
What are the long-term clinical outcomes of isolated saphenous vein bypass grafts to the left anterior descending artery?
Isolated saphenous vein bypass grafts to the LAD demonstrate acceptable long-term outcomes, suggesting that internal mammary artery grafts may not be universally imperative and should be tailored to individual patient considerations.
To establish a benchmark for the clinical efficacy of PTCA and the IMA graft in our institution, the data from 79 patients who underwent isolated SVBG to the LAD between July, 1971, and December, 1984, were analyzed. Follow-up averaged 96.16 months/patient. Actuarial freedom from reoperation was 100% at 12 months, 95% at 60 months, and 89.4% at 120 months. Actuarial freedom from cardiac death was 100% at 12 months, 94% at 60 months, and 87% at 120 months. Actuarial freedom from an LAD graft failure myocardial event was 100% at 12 month, 94% at 60 months, and 77% at 120 months. Our SVBG failure rate did increase from 1.2%/year during the first 5 years to 3.4%/year during the second 5 years. We are presently selectively employing IMA grafts to the LAD. Our results with the SVBG and the palliative nature of all coronary artery bypass graft procedures remove the imperative to always use the IMA. Individual patient considerations such as age, clinical stability, IMA flow, and the residual anatomy for the potential reoperation are important considerations.
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Enright et al. (1987) conducted a cohort in Coronary artery disease requiring bypass (n=79). Isolated saphenous vein bypass graft (SVBG) to the LAD was evaluated on Actuarial freedom from an LAD graft failure myocardial event at 120 months. Isolated saphenous vein bypass grafting to the LAD demonstrated actuarial freedom from cardiac death of 87% and freedom from LAD graft failure myocardial events of 77% at 120 months.
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