One-year Graft Patency after Coronary Artery Bypass Surgery

Kim, Ki Bong; Kim, Hyun Jo; Sung, Ki Ick

Abstract

Between July 1994 and August 1995, 78 patients underwent coronary artery bypass graft at Seoul National University Hospital. Coronary angiogram was performed one year after coronary artery bypass graft in 49 patients(62.8%) for evaluation of the graft patency and analysis of the risk factors for graft occlusion. The patency rates of both the internal mammary artery and the radial artery grafts were 100%, although three internal mammary artery grafts(5.0%) were narrowed(string sign). And that of the saphenous vein grafts were 85.2%. Multivariate analysis for the preoperative, operative, and postoperative factors was done between the widely patent and the narrowed internal mammary artery graft groups, and between the patent and the occluded saphenous vein graft groups by the general linear models procedure. Patient's age(>or=60 years), postoperative intraaortic balloon pump insertion, bleeding, and acute renal failure were found to be the significant risk factors for internal mammary artery graft narrowing, and coronary artery size(<1.5 mm) was the significant risk factor for the saphenous vein graft occlusion (p<0.05). This study confirms that the arterial graft is superior to the vein graft at one-year patency rate, and suggests the risk factors for graft occlusion during the first postoperative year. Knowledge of this study may provide a basis for estimating the risk factors for graft occlusion, and thereby modifying surgical strategy and postoperative surveillance.