Choice of conduit for coronary artery bypass grafting in poor ventricles

Abstract

advantages in the use of arterial grafts for coronary artery revascularizations have been reported previously. we aimed to compare the outcome and survival rates of different conduits in patients with poor ventricular function (ejection fraction<30%). in a 10-year period, 979 patients with an ejection fraction<30%, who underwent isolated first-time coronary artery bypass grafting, were divided into in 3 groups: (A) total arterial grafts (n=257), (B) total vein grafts (n=76), and (C) left internal mammary artery and vein grafts (n=610). Multivariate logistic regression was used to assess the effect of graft type on mortality, while adjusting for patient and disease characteristics. Hospital mortality and 5-year survival rates were compared among the groups. hospital mortality was 8.9% for group A, 11.8% for group B, and 5.7% for group C. Mortality at 5 years was 27.2% for group A, 42.3% for group B, and 28.7% for group C. After risk adjustment, hospital mortality and mid- and long-term mortality showed no significant differences among the groups. patients with poor ventricular function have a high mortality rate in both the short- and long-term with any type of conduit. Mortality rates with total arterial grafts and vein plus arterial grafts were comparable before and after risk adjustment.