Does Beating Heart Surgery or Haemofiltration Attenuate Inflammatory Response to Cardiopulmonary Bypass

Abstract

greater than 10 years is unknown. Method: Only patients with all three conduits: internal mammary (IMA), radial artery (RA) and venous grafts (SVG) enrolled in non-randomised prospective research protocol angiography where the duration postoperative was a minimum of 10 years. Within each patient, all three conduits were exposed to the same patient, systemic disease and medication factors. Graft patency for each anastomosis was recorded as patent or occluded. Patency was a widely open lumen even in the presence of lumen irregularity; and perfect patency was patent grafts where there was no irregularity of the conduit lumen (entirely normal conduit). An irregular lumen occurs with conduit atheroma and predicts ongoing graft failure in the longer term. Results: 40 patients, 39 male, underwent elective research coronary angiography at 13.2 2.6 (10-18) yr postoperative. Age at operation was 61.3 8.2 yr, and at late angiography was 74.5 7.7 yr. Symptoms of any kindwere infrequent; CCS 0/I in 98% and NYHA I/II in 98%. 155 grafts by distal anastomosis; IMA 48, RA 62, SVG 45. Patency was IMA 96% (46/48) and was not different to RA 94% (58/62) (p=0.695). All patent arterial conduits were perfectly patent. SVG patency was 78% (35/45), which was inferior to arterial grafts (p=0.003), but higher than that expected from the literature. Perfect patency was 16% (7/45), which is significantly lower than IMA (p 10 years, RA patency is not significantly different to IMA patency and all patent arterial grafts appeared normal. Venous grafts had significantly lower patency and perfect patency compared to arterial grafts.