Successful interposition synthetic graft between aorta and right coronary artery. Angiographic follow-up to sixteen months.

A knitted Dacron filamentous vascular prosthesis, 4 cm. long and 3.5 mm. in diameter, was used as an interposition graft between the aorta and right coronary artery in a 65-year-old woman on Oct. 25, 1974. The prosthesis was used to transplant the right coronary artery incident to removal of a saccular aneurysm if the ascending aorta. Concomitant mitral valve replacement and tricuspid annuloplaty were performed. The graft was demonstrated patent by angiograms 2 weeks, 7 months, and 16 months after the operation, and the patient continues to be clinically well 17 months postoperatively. The literature records the successful use of aorta-coronary Dacron prostheses in 2 other patents, both children with coronary anomalies. One of these grafts closed after a while: the second was demonstrated patent by angiograms 8 years after implantation. These cases demonstrate that prostheses can function in the aorta-coronary position, and the reports of saphenous vein failures indicate the need for a reasonable substitute when a patient's saphenous veins are absent or inadequate. In all 3 cases, the prostheses were quite short and were used as interposition grafts between the ascending aorta and the proximal end of the coronary artery. Our review did not reveal successful use of a synthetic graft for aorta-coronary bypass.