Long-term follow-up of patients undergone coronary artery bypass grafting with exclusive use of arterial grafts

Rev Bras Cir Cardiovasc. 2008 Oct-Dec;23(4):494-500. doi: 10.1590/s0102-76382008000400007.
[Article in English, Portuguese]

Abstract

Objective: To evaluate the long-term results of the coronary artery bypass grafting with exclusive use of arterial grafts for patients with triple vessel disease.

Methods: We evaluated 136 patients who underwent isolated coronary artery bypass grafting between January 1995 and December 1997. 353 grafts were used for revascularization of 449 arteries (mean: 3.30 per patient). Grafts used were left internal thoracic artery (99.2%), right internal thoracic artery (56.6%), radial artery (87.5%), right gastroepiploic artery (20.5%) and one inferior epigastric artery. 76 (55.8%) patients received composite grafts ('Y' shape) and 66 (48.5%) patients received sequential anastomoses.

Results: Hospital mortality was 4.4%. In the long-term follow-up (9.5 to 12.8 years), 82.1% of the patients were free of cardiac events. 20 (17.9%) patients had hospital readmission due to cardiac events: 15 presented angina and five presented acute myocardial infarction, and three of them presented associated heart failure. Eighth (7.1%) patients needed coronary reintervention: one of them underwent coronary bypass reoperation and the others underwent coronary angioplasty with stent. Estimated probability of cardiac event-free was 98.2%, 95.4% e 84.2% at 1, 5 and 10 years follow-up respectively. There were 16 (14.2%) late deaths and four of them (3.6%) were cardiac-related. Actuarial 12.8-year-survival of all deaths was 85% in this group.

Conclusion: Coronary artery bypass grafting with exclusive use of arterial grafts is a safe procedure for patients with triple vessel coronary disease with good long-term results.

MeSH terms

  • Adult
  • Aged
  • Angina Pectoris / epidemiology
  • Angina Pectoris / etiology
  • Brazil / epidemiology
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods*
  • Coronary Artery Bypass / mortality
  • Coronary Artery Disease / surgery*
  • Female
  • Follow-Up Studies
  • Gastroepiploic Artery / transplantation*
  • Hospital Mortality
  • Humans
  • Male
  • Mammary Arteries / transplantation*
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology
  • Radial Artery / transplantation*
  • Reoperation / statistics & numerical data
  • Survival Analysis
  • Treatment Outcome