Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting
Objective: Little is known about the fate of bypass grafts to the right coronary system. To investigate the long-term patency of venous bypass grafts directed to the right coronary artery (RCA) based on postoperative angiograms and to identify predictors of graft occlusion. Methods: In this single-c...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/9/285 |
| _version_ | 1827660092345942016 |
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| author | Rawa Arif Aglaia Warninck Mina Farag Wiebke Sommer Florian Leuschner Norbert Frey Matthias Karck Gregor Warnecke Nicolas A. Geis |
| author_facet | Rawa Arif Aglaia Warninck Mina Farag Wiebke Sommer Florian Leuschner Norbert Frey Matthias Karck Gregor Warnecke Nicolas A. Geis |
| author_sort | Rawa Arif |
| collection | DOAJ |
| description | Objective: Little is known about the fate of bypass grafts to the right coronary system. To investigate the long-term patency of venous bypass grafts directed to the right coronary artery (RCA) based on postoperative angiograms and to identify predictors of graft occlusion. Methods: In this single-center study, all patients who underwent coronary angiography from 2005 to 2021 after previously undergoing isolated coronary artery bypass grafting (CABG) were included. The primary endpoint was graft occlusion over a median follow-up of 9.1 years. Results: Among a total of 1106 patients (17.0% women, 64 (57–71) years median age), 289 (26.1%) received a sequential vein graft and 798 (72.2%) a single graft. Multivariate regression revealed age (HR 1.019, CI 95% 1.007–1.032), the urgency of CABG (HR 1.355, CI 95% 1.108–1.656), and severely impaired left ventricular function (HR 1.883, CI 95% 1.290–2.748), but not gender and chronic total occlusion (CTO) as predictive factors for graft occlusion. Single conduits were found to be a predictor of graft patency (HR 0.575 CI 95% 0.449–0.737). The angiographic outcome showed an overall 10-year freedom from graft occlusion of 73.4% ± 1.6%. The 5-year (10-year) freedom from graft occlusion was 76.9% ± 2.8% (57.8% ± 4.0%) for sequential grafts and 90.4% ± 1.1% (77.8% ± 1.7%) for single grafts (log-rank <i>p</i> < 0.001). Conclusions: In symptomatic patients with renewed angiography, venous bypass grafting of the RCA showed acceptable long-term patency rates. Single bypass grafting of the RCA was superior to sequential grafting, which needs to be further investigated. |
| first_indexed | 2024-03-09T23:38:11Z |
| format | Article |
| id | doaj.art-9aef5ac5358d4c419d3c99c76e75d57d |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T23:38:11Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-9aef5ac5358d4c419d3c99c76e75d57d2023-11-23T16:57:05ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-08-019928510.3390/jcdd9090285Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass GraftingRawa Arif0Aglaia Warninck1Mina Farag2Wiebke Sommer3Florian Leuschner4Norbert Frey5Matthias Karck6Gregor Warnecke7Nicolas A. Geis8Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, GermanyDepartment of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, 69120 Heidelberg, GermanyObjective: Little is known about the fate of bypass grafts to the right coronary system. To investigate the long-term patency of venous bypass grafts directed to the right coronary artery (RCA) based on postoperative angiograms and to identify predictors of graft occlusion. Methods: In this single-center study, all patients who underwent coronary angiography from 2005 to 2021 after previously undergoing isolated coronary artery bypass grafting (CABG) were included. The primary endpoint was graft occlusion over a median follow-up of 9.1 years. Results: Among a total of 1106 patients (17.0% women, 64 (57–71) years median age), 289 (26.1%) received a sequential vein graft and 798 (72.2%) a single graft. Multivariate regression revealed age (HR 1.019, CI 95% 1.007–1.032), the urgency of CABG (HR 1.355, CI 95% 1.108–1.656), and severely impaired left ventricular function (HR 1.883, CI 95% 1.290–2.748), but not gender and chronic total occlusion (CTO) as predictive factors for graft occlusion. Single conduits were found to be a predictor of graft patency (HR 0.575 CI 95% 0.449–0.737). The angiographic outcome showed an overall 10-year freedom from graft occlusion of 73.4% ± 1.6%. The 5-year (10-year) freedom from graft occlusion was 76.9% ± 2.8% (57.8% ± 4.0%) for sequential grafts and 90.4% ± 1.1% (77.8% ± 1.7%) for single grafts (log-rank <i>p</i> < 0.001). Conclusions: In symptomatic patients with renewed angiography, venous bypass grafting of the RCA showed acceptable long-term patency rates. Single bypass grafting of the RCA was superior to sequential grafting, which needs to be further investigated.https://www.mdpi.com/2308-3425/9/9/285coronary artery disease (CAD)coronary artery bypass grafting (CABG)coronary artery graft patencyright coronary artery |
| spellingShingle | Rawa Arif Aglaia Warninck Mina Farag Wiebke Sommer Florian Leuschner Norbert Frey Matthias Karck Gregor Warnecke Nicolas A. Geis Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting Journal of Cardiovascular Development and Disease coronary artery disease (CAD) coronary artery bypass grafting (CABG) coronary artery graft patency right coronary artery |
| title | Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting |
| title_full | Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting |
| title_fullStr | Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting |
| title_full_unstemmed | Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting |
| title_short | Long-Term Patency of Venous Conduits Targeting the Right Coronary Artery System—Single Is Superior to Sequential bypass Grafting |
| title_sort | long term patency of venous conduits targeting the right coronary artery system single is superior to sequential bypass grafting |
| topic | coronary artery disease (CAD) coronary artery bypass grafting (CABG) coronary artery graft patency right coronary artery |
| url | https://www.mdpi.com/2308-3425/9/9/285 |
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