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Selected Publication:
Meinelt, N.
Evaluation of alternative grafts in coronary artery bypass surgery - Evaluation of long-term results by Cardiac CT
[ Diplomarbeit ] Medical University of Graz; 2013. pp. 80
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- Authors Med Uni Graz:
- Advisor:
- Marsoner Katharina
- Yates Ameli
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- Abstract:
- Background: Alternative graft material (cephalic vein (CV), small saphenous vein (SSV), biocompound-supported vein graft) comes to use when conventional material isn´t available. Due to lack of information the choice of grafts has so far not been supported by scientific data. The aim of this study was to evaluate alternative graft material in a case series, that came to use at our institution. Methods: From altogether 1570 patients (coronary artery bypass graft (CABG) between 2008 and 2011 at the Department of Cardiac Surgery at the university hospital in Graz) 36 patients who received alternative conduits were selected to evaluate the long-term patency of the alternative conduits by Cardiac computed tomography (CT). 24 of the 36 were primarily excluded, 12 were invited and finally seven of them examined. Three patients consented in using results from coronary angiography (conducted independently from the study), which made a total of ten patients with 20 alternative conduits (six CV conduits, six SSV conduits, eight biocompound-supported GSV conduits). Results: Two SSV conduits and two CV conduits could postoperatively not be assigned definitely. From the remaining four CV grafts zero were patent and all four occluded (patency rate 0%), from the four SSV grafts three remained patent and one was occluded (75% patency rate). Three of eight biocompound-supported GSV grafts remained patent and five were occluded, which equals a patency rate of 37,5%. Discussion: Due to a small number of participants our study is not representative for long-term patency rates of alternative conduits. To make a statement about the usability of alternative graft material, our results were compared to other studies thematizing the same subject. Conclusion: Alternative graft material shows very variable outcome but compared to conventional bypass grafts, especially arterial conduits, evermore poorer results in terms of long-term patency. Therefore it should only be used for coronary artery bypass grafts when any other (arterial) graft material is unavailable or unsuitable.