Comparison of Patency of the Saphenous Vein and Left Internal Mammary Artery in Left Descending Coronary Artery Bypass Graft Position

Abstract

Abstract Objective: We aimed to evaluate long-term patency rates and clinical outcomes of the saphenous vein (SVG) and left internal mammary artery (LIMA) in left anterior descending coronary artery (LAD) position to investigate the optimum conduit for coronary artery bypass graft (CABG) operations. In addition we investigated the SVG patency in the other coronary artery positions. Methods: From January 2012 to November 2014, there were 178 patients who were previously undergone coronary artery bypass surgery and had ischemic symptoms, were restudied with coronary angiography in our hospital. We evaluated the preoperative and postoperative data of those patients. The patients were divided into two groups according to the graft anastamosed to LAD; LIMA group and SVG group. Grafts are defined as failed if there was occlusion, string sign, or greater than 80% stenosis. We analyzed also other coronary artery targets by subgroup analysis. Results: There were no significant differences between each group in preoperative comorbidity, age, or urgency. The mean follow-up time of the patients were 48 months in SVG group and 60 months in LIMA group. Occlusion rates of the LIMA grafts were lower than SVG (9.9% vs. 22.2% p =0.001). Subgroup analysis revealed that, as a target vessel diagonal coronary artery has the lowest SVG patency rates (46.9%, p =0.005). Conclusion: Selection of arterial or venous conduit for the left descending coronary artery has significantly affected both patency rate and symptom-free period. In addition, saphenous vein grafts has the lowest patency rates when anastamosed to the diagonal artery.