Abstract
Background: Left internal mammary arteries (LIMAs) and saphenous vein grafts (SVGs) are widely used for coronary artery bypass surgery (CABG), but there is limited information on the post-CABG remodeling of these vessels, as well as the bypassed native coronary arteries. We aimed to investigate the serial changes in lumen dimensions of SVGs, LIMAs and the bypassed native arteries in humans. Methods: Thirteen consecutive patients with recent CABG enrolled in our study and underwent angiography immediately after the surgery and one year later. Quantitative coronary analysis (using CAAS Workstation 5.11 software) was performed in 12 LIMAs, 26 SVGs and 59 native coronary arteries that were bypassed. Results: Mean age was 60.8±5.8 years and all the study patients were men while the initial clinical presentation was stable angina (76.9%). Compared to immediately post CABG, at 12 month follow-up angiography the minimal, maximal and mean SVG lumen diameters of the SVGs significantly decreased: (2.83±0.87mm vs 1.99±0.79mm, p<0.0001; 5.10±1.52mm vs 3.82±1.20mm, p<0.0001; 3.96±1.22mm vs 2.75±0.97mm, p<0.0001; respectively). No significant differences were observed in the baseline and follow-up measurements of LIMA grafts (minimal lumen diameter 1.31± 0.78mm vs 0.86±0.72mm, p=0.17; maximal lumen diameter 2.74±1.25mm vs 2.28mm±1.52, p=0.31; mean lumen diameter 0.62±0.45mm vs 1.02±1.12mm, p=0.24) and the native coronary vessels (minimal lumen diameter 0.76±0.40mm vs 0.82±0.46mm, p=0.31; maximal lumen diameter 2.88±0.99mm vs 3.07±1.18mm, p=0.09; mean lumen diameter 1.84±0.65mm vs 1.86±0.76mm, p=0.74). Conclusions: During the first year post CABG SVGs undergo significant negative remodeling, inferred by lumen constriction, which is not observed in LIMA grafts and the grafted native coronary arteries. The impact of this negative remodeling on clinical outcomes remains to be determined.
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