Graft pathology at the time of harvest: impact on long-term survival
Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, an...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cirurgia Cardiovascular
2014-12-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000400011&lng=en&tlng=en |
| _version_ | 1818252905366421504 |
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| author | Shi-Min Yuan Yun Li Yan Hong Ben Xiao Feng Cheng Da Zhu Li De Min Li Hua Jing |
| author_facet | Shi-Min Yuan Yun Li Yan Hong Ben Xiao Feng Cheng Da Zhu Li De Min Li Hua Jing |
| author_sort | Shi-Min Yuan |
| collection | DOAJ |
| description | Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA), radial artery and saphenous vein grafts. There were 2 (3.0%) hospital deaths and 9 (14.1%) late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002); whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts. |
| first_indexed | 2024-12-12T16:31:36Z |
| format | Article |
| id | doaj.art-4276fa9094a54b1d9cd2dbd16537cdb9 |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-12-12T16:31:36Z |
| publishDate | 2014-12-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-4276fa9094a54b1d9cd2dbd16537cdb92022-12-22T00:18:45ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412014-12-0129454355110.5935/1678-9741.20140118S0102-76382014000400011Graft pathology at the time of harvest: impact on long-term survivalShi-Min YuanYun LiYan Hong BenXiao Feng ChengDa Zhu LiDe Min LiHua JingObjective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA), radial artery and saphenous vein grafts. There were 2 (3.0%) hospital deaths and 9 (14.1%) late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002); whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000400011&lng=en&tlng=enPonte de Artéria CoronáriaPatologiaAnálise de SobrevidaArtéria Torácica Interna |
| spellingShingle | Shi-Min Yuan Yun Li Yan Hong Ben Xiao Feng Cheng Da Zhu Li De Min Li Hua Jing Graft pathology at the time of harvest: impact on long-term survival Brazilian Journal of Cardiovascular Surgery Ponte de Artéria Coronária Patologia Análise de Sobrevida Artéria Torácica Interna |
| title | Graft pathology at the time of harvest: impact on long-term survival |
| title_full | Graft pathology at the time of harvest: impact on long-term survival |
| title_fullStr | Graft pathology at the time of harvest: impact on long-term survival |
| title_full_unstemmed | Graft pathology at the time of harvest: impact on long-term survival |
| title_short | Graft pathology at the time of harvest: impact on long-term survival |
| title_sort | graft pathology at the time of harvest impact on long term survival |
| topic | Ponte de Artéria Coronária Patologia Análise de Sobrevida Artéria Torácica Interna |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000400011&lng=en&tlng=en |
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