Ho Young Hwang1, Kyung-Hak Lee2, Jung Wook Han3, Ki-Bong Kim4. 1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. 2. Department of Thoracic and Cardiovascular Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, Korea. 3. Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon-si, Gyeonggi-do, Korea. 4. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. Electronic address: kimkb@snu.ac.kr.
Abstract
BACKGROUND: We compared 5-year graft patency rates and midterm clinical outcomes of saphenous vein (SV) composite grafts with those of total arterial (TA) composite grafts in patients who underwent off-pump coronary artery bypass graft surgery (OPCAB). METHODS:Three hundred sixty-three patients who underwent OPCAB using composite grafts based on the left internal thoracic artery were studied. The SV was used as a second (connected to the left internal thoracic artery) or a third (connected to the second arterial graft) composite graft in 90 patients (SV group); TA composite grafting was performed in 273 patients (TA group). Follow-up was complete in 96.4% of patients (350 of 363), with a median follow-up of 82 months. Five-year graft patency rates and long-term clinical outcomes were compared. A propensity score-matched analysis was also performed to minimize differences in preoperative and intraoperative variables (n = 69 in each group). RESULTS: There were no differences in operative mortality and postoperative complications between the SV group and TA group. Actuarial 5-year patency rates of the venous and arterial composite grafts were 89.3% and 89.5%, respectively (p = 0.958). Those were also similar between the two propensity score-matched SV and TA groups (90.5% and 89.3%, respectively; p = 0.759). Five-year overall survival and freedom from major adverse cardiac and cerebrovascular events were 88.5% and 85.6%, respectively. Those were similar between the two groups before and after propensity score matching. CONCLUSIONS: The SV composite grafts were equivalent to arterial composite grafts in terms of 5-year graft patency rates and midterm clinical outcomes.
RCT Entities:
BACKGROUND: We compared 5-year graft patency rates and midterm clinical outcomes of saphenous vein (SV) composite grafts with those of total arterial (TA) composite grafts in patients who underwent off-pump coronary artery bypass graft surgery (OPCAB). METHODS: Three hundred sixty-three patients who underwent OPCAB using composite grafts based on the left internal thoracic artery were studied. The SV was used as a second (connected to the left internal thoracic artery) or a third (connected to the second arterial graft) composite graft in 90 patients (SV group); TA composite grafting was performed in 273 patients (TA group). Follow-up was complete in 96.4% of patients (350 of 363), with a median follow-up of 82 months. Five-year graft patency rates and long-term clinical outcomes were compared. A propensity score-matched analysis was also performed to minimize differences in preoperative and intraoperative variables (n = 69 in each group). RESULTS: There were no differences in operative mortality and postoperative complications between the SV group and TA group. Actuarial 5-year patency rates of the venous and arterial composite grafts were 89.3% and 89.5%, respectively (p = 0.958). Those were also similar between the two propensity score-matched SV and TA groups (90.5% and 89.3%, respectively; p = 0.759). Five-year overall survival and freedom from major adverse cardiac and cerebrovascular events were 88.5% and 85.6%, respectively. Those were similar between the two groups before and after propensity score matching. CONCLUSIONS: The SV composite grafts were equivalent to arterial composite grafts in terms of 5-year graft patency rates and midterm clinical outcomes.
Authors: Etem Caliskan; Domingos Ramos de Souza; Andreas Böning; Oliver J Liakopoulos; Yeong-Hoon Choi; John Pepper; C Michael Gibson; Louis P Perrault; Randall K Wolf; Ki-Bong Kim; Maximilian Y Emmert Journal: Nat Rev Cardiol Date: 2019-08-27 Impact factor: 32.419
Authors: Ho Young Hwang; Sang Yoon Yeom; Jae Woong Choi; Se Jin Oh; Eun Ah Park; Whal Lee; Ki Bong Kim Journal: J Korean Med Sci Date: 2017-12 Impact factor: 2.153