Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: Results from a Department of Veterans Affairs Cooperative Study

Steven Goldman, Karen Zadina, Thomas Moritz, Theron Ovitt, Gulshan Sethi, Jack G. Copeland, Lizy Thottapurathu, Barbara Krasnicka, Nancy Ellis, Robert J. Anderson, William Henderson

Research output: Contribution to journalArticle

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Abstract

This study defined long-term patency of saphenous vein grafts (SVG) and internal mammary artery (IMA) grafts. This VA Cooperative Studies Trial defined 10-year SVG patency in 1,074 patients and left IMA patency in 457 patients undergoing coronary artery bypass grafting (CABG). Patients underwent cardiac catheterizations at 1 week and 1, 3, 6, and 10 years after CABG. Patency at 10 years was 61% for SVGs compared with 85% for IMA grafts (p < 0.001). If a SVG or IMA graft was patent at 1 week, that graft had a 68% and 88% chance, respectively, of being patent at 10 years. The SVG patency to the left anterior descending artery (LAD) (69%) was better (p < 0.001) than to the right coronary artery (56%), or circumflex (58%). Recipient vessel size was a significant predictor of graft patency, in vessels >2.0 mm in diameter SVG patency was 88% versus 55% in vessels ≤2.0 mm (p < 0.001). Other positive significant predictors of graft patency were use of aspirin after bypass, older age, lower serum cholesterol, and lowest Canadian Functional Class (p < 0.001 to 0.058). The 10-year patency of IMA grafts is better than SVGs. The 10-year patency for SVGs is better and the 10-year patency for IMA grafts is worse than expected. The 10-year patency of SVGs to the LAD is better than that to the right or circumflex. The best long-term predictors of SVG graft patency are grafting into the LAD and grafting into a vessel that is >2.0 mm in diameter.

Original languageEnglish (US)
Pages (from-to)2149-2156
Number of pages8
JournalJournal of the American College of Cardiology
Volume44
Issue number11
DOIs
StatePublished - Dec 7 2004
Externally publishedYes

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Mammary Arteries
Saphenous Vein
Veterans
Coronary Artery Bypass
Transplants
Cardiac Catheterization

ASJC Scopus subject areas

  • Nursing(all)

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Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery : Results from a Department of Veterans Affairs Cooperative Study. / Goldman, Steven; Zadina, Karen; Moritz, Thomas; Ovitt, Theron; Sethi, Gulshan; Copeland, Jack G.; Thottapurathu, Lizy; Krasnicka, Barbara; Ellis, Nancy; Anderson, Robert J.; Henderson, William.

In: Journal of the American College of Cardiology, Vol. 44, No. 11, 07.12.2004, p. 2149-2156.

Research output: Contribution to journalArticle

Goldman, Steven ; Zadina, Karen ; Moritz, Thomas ; Ovitt, Theron ; Sethi, Gulshan ; Copeland, Jack G. ; Thottapurathu, Lizy ; Krasnicka, Barbara ; Ellis, Nancy ; Anderson, Robert J. ; Henderson, William. / Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery : Results from a Department of Veterans Affairs Cooperative Study. In: Journal of the American College of Cardiology. 2004 ; Vol. 44, No. 11. pp. 2149-2156.
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abstract = "This study defined long-term patency of saphenous vein grafts (SVG) and internal mammary artery (IMA) grafts. This VA Cooperative Studies Trial defined 10-year SVG patency in 1,074 patients and left IMA patency in 457 patients undergoing coronary artery bypass grafting (CABG). Patients underwent cardiac catheterizations at 1 week and 1, 3, 6, and 10 years after CABG. Patency at 10 years was 61{\%} for SVGs compared with 85{\%} for IMA grafts (p < 0.001). If a SVG or IMA graft was patent at 1 week, that graft had a 68{\%} and 88{\%} chance, respectively, of being patent at 10 years. The SVG patency to the left anterior descending artery (LAD) (69{\%}) was better (p < 0.001) than to the right coronary artery (56{\%}), or circumflex (58{\%}). Recipient vessel size was a significant predictor of graft patency, in vessels >2.0 mm in diameter SVG patency was 88{\%} versus 55{\%} in vessels ≤2.0 mm (p < 0.001). Other positive significant predictors of graft patency were use of aspirin after bypass, older age, lower serum cholesterol, and lowest Canadian Functional Class (p < 0.001 to 0.058). The 10-year patency of IMA grafts is better than SVGs. The 10-year patency for SVGs is better and the 10-year patency for IMA grafts is worse than expected. The 10-year patency of SVGs to the LAD is better than that to the right or circumflex. The best long-term predictors of SVG graft patency are grafting into the LAD and grafting into a vessel that is >2.0 mm in diameter.",
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