Lower versus upper leg saphenous vein composite grafts based on the left internal thoracic artery: A randomized study

The Journal of Thoracic and Cardiovascular Surgery

Jeong-Wook Seo¹  Hyoung Woo Chang²  Ho Young Hwang³ 

[1] Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon-si, Gyeonggi-do, Republic of Korea;Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

关键词: saphenous vein;    coronary artery bypass grafting;    anatomy;    patency;   

DOI  :  10.1016/j.jtcvs.2018.03.148

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

ObjectivesThe "lower versus upper leg saphenous vein (SV) composite graft based on the left internal thoracic artery (ITA) for coronary artery bypass grafting" trial was designed to compare the histologic, immunohistochemical, and angiographic findings of lower versus upper leg SV composite grafts.MethodsTwenty-six patients with multivessel coronary artery disease were prospectively randomized to undergo revascularization using a lower leg (n = 13) or upper leg (n = 13) SV composite graft based on the in situ left ITA. The SV was harvested with a "no-touch" technique, and 2 excess segments were removed from the distal and proximal portions of each SV conduit. Another proximal segment was removed from the reversed SV composite graft, which had been dilated by the native ITA pressure. Hematoxylin and eosin staining, immunohistochemistry, and early and 1-year postoperative angiographic results were compared.ResultsThe histologic study showed that the proximal and dilated proximal SV conduit lumen diameters were smaller in the lower leg group than in the upper leg group (proximal, 623 ± 143 μm vs 858 ± 266 μm; P = .008; dilated proximal, 1138 ± 419 μm vs 1477 ± 353 μm; P = .047). However, there were no differences in the lumen diameters of the distal SV segments in terms of immunohistochemical comparisons, diameters, patency rates, or filling frame counts of the SV conduits on early and 1-year postoperative angiograms between the 2 groups.ConclusionsAlthough the proximal segment luminal diameters were smaller in the lower leg SV, there were no differences in the immunohistochemical results or patency rates on early and 1-year postoperative angiograms between the lower and upper leg "no-touch" SV conduits.

【 授权许可】

Unknown