Coronary Artery Grafting with the Saphenous Vein or Internal Mammary Artery
Key result
IMA grafting linked to ~3% higher one-year patency versus saphenous vein grafts despite lower blood flow.
- P<0.001
Why the study?
Does internal mammary artery grafting improve patency and blood flow compared to saphenous vein grafting in patients undergoing coronary artery bypass?
Population
Consecutive patients who underwent coronary artery grafting
Comparison
Internal mammary artery (IMA) grafting vs Saphenous vein grafting
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Comparable patency with lower IMA flow should not yet change graft selection; leaves open randomized trials on flow and outcomes.
Study Design
Type
Cohort
Structured PICO
Does internal mammary artery grafting improve patency and blood flow compared to saphenous vein grafting in patients undergoing coronary artery bypass?
P
Population
Consecutive patients who underwent coronary artery grafting with either the saphenous vein or the internal mammary artery, evaluated at two weeks and one year post-operation.
E
Exposure
Internal mammary artery (IMA) grafting
C
Comparator
Saphenous vein grafting
O
Outcome
Cumulative graft patency rate at one year assessed by angiographysurrogate
Main Result
Absolute Event Rate: 88.3% vs 84.9%
Although IMA and saphenous vein grafts have comparable 1-year patency rates, vein grafts provide significantly higher blood flow, suggesting IMA should be reserved for grafting small coronary arteries unless it is of large caliber.
Cite This Study
Grondin et al. (1975) conducted a cohort in Coronary artery disease requiring grafting. Internal mammary artery (IMA) grafting vs. Saphenous vein grafting was evaluated on Cumulative patency rate at one year. Internal mammary artery grafting showed a cumulative patency rate of 88.3% at one year compared to 84.9% for saphenous vein grafts, though blood flow was significantly lower (P<0.001).