Comparative study of various autoarterial and venous grafts according to bypass angiography after coronary artery bypass grafting

Two hundred forty two postsurgical angiograms were studied (172 - arterial, 70 - venous). The mean interval from the initial surgery to the postoperative angiogram was 18,2±2,4 months. Internal thoracic artery (ITA) in situ - 117, internal thoracic artery free graft - 6, the radial artery (RA) - 49, and veis saphenous magnas (VSM) - 70 were studied. Influence of vessel conduit: The best graft patency was in ITA in situ - 89 (76%) of 117 grafts (р=0,232); good results occurred when using RA - 35 (71%) of 49 grafts (р=0,232); and the worst graft patency was in VSM - 29 (41,4%) of 70 (р=0,028). Influence of territory grafted by arterial conduit: The best patency was in arterial conduits grafting left coronary artery (LCA) and diagonal coronary artery (DA) as a sequential graft - 12 (92,3%) of 13 (р=0,001); LCA - 51 (83,6%) of 61 (р=0,001); DA - 7 (77,8%) of 9 (р=0,001). High rate of occlusions occurred in the right coronary artery (RCA) - 14 (25,9%) of 54 (р=0,004); posterior descending artery (PDA) - 6 (21,4%) of 28 (р=0,004); left ventricular branch - 2 (28,6%) of 7 (р=0,004). Influence of congenital coronary stenosis: when congenital coronary artery stenosis was more then 70%, 30 of 35 grafts were patent (85,7%) when congenital coronary stenosis was less than 70%, 5 of 14 grafts were patent (35,7%). Late patency of arterial grafts is excellent and justifies continuing use and study in coronary surgery.