Background: We compared midterm clinical outcomes and 1-year graft patency rates of saphenous vein composite grafts with those of total arterial composite grafts in patients who underwent off-pump coronary artery bypass grafting (OPCAB).
Methods: Three hundred forty patients who underwent OPCAB using composite grafts based on the left internal thoracic artery were studied. Total arterial revascularization using arterial composite grafts was performed in 263 patients (ART group) and the saphenous vein was used as an additional composite graft in 77 patients (SVG group). Clinical outcomes and early and 1-year postoperative angiographic results were compared.
Results: No differences in early mortality or perioperative complications were observed between the groups. Early postoperative (1.7 + or - 1.7 days) angiography demonstrated a saphenous vein graft patency rate of 97.1% (132 of 136), which was not different from that of arterial composite grafts (98.7% [631 of 639], p = 0.240). One-year postoperative (12 + or - 1 months) angiography showed an overall patency rate of 93.4% (886 of 949). The patency rate of saphenous vein grafts at 1 year was 92.1% (105 of 114), which was similar to that of arterial composite grafts (91.0% [499 of 550], p = 0.640). Patency rates of venous grafts according to target coronary artery territories were also similar to those of arterial composite grafts. Reintervention-free survival rates at 2 years were 90.6% (ART) and 91.3% (SVG) (p = 0.970). No differences were observed in overall survival rates between the groups (p = 0.792).
Conclusions: Our clinical and angiographic results demonstrated that the saphenous vein may be used as an alternative composite graft to the arterial composite graft.
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.