PMID- 9892480
OWN - NLM
STAT- MEDLINE
DCOM- 19990325
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 13
IP  - 1
DP  - 1998 Jan
TI  - Coronary artery bypass with "snake" grafts: fifteen-year follow-up.
PG  - 18-23
AB  - BACKGROUND: Since 1970 we have used the "snake" graft in more than 8000 cases of 
      coronary artery bypass grafting (CABG). We followed, for over 15 years, 214 
      patients who underwent CABG in 1981 with only a "snake" graft by one surgeon 
      (William H. Sewell, M.D.). METHODS: Eighty-four percent (180/214) were male and 
      16% (34/214) were female with an average age of 58 and 66 years, respectively. 
      The average left ventricular ejection fraction (LVEF) was > 55% in 63% (135/214) 
      of the patients and < 55% in 37% (79/214); 15% (33/214) had diabetes and 77% 
      (164/214) were smokers. The mean preoperative New York Heart Association (NYHA) 
      functional class was 3.1+/-0.6 (range I-IV). Diagnostic arteriography 
      demonstrated two vessel disease in 5% (9/214), three vessel disease in 89% 
      (191/214), and left main disease in 6% (14/214). The average number of distal 
      grafts per patient was 3.4. Coronary arteriography was performed 8-weeks 
      postoperatively. Annual follow-up with a questionnaire determined incidence of 
      redo procedures and survival. RESULTS: The perioperative 30-day mortality was 1% 
      (2/214). At 8 weeks there was a graft patency rate end-to-side of 85%, 
      side-to-side 97%, and the proximal segment of 95%. Four percent (9/214) had redo 
      surgery while 6% (13/214) underwent angioplasty during the 15 years. Sixty-seven 
      percent (144/214) were alive at 15 years with a significantly improved mean NYHA 
      functional class of 1.2+/-0.9 (p < 0.001). Twenty-four percent of those 166 live 
      patients (35/144) had an average LVEF of 50% by echocardiography. There were 34 
      (16%) noncardiac deaths, 32 (15%) cardiac deaths, and 2 (1%) unknown causes. 
      CONCLUSIONS: The results of this study suggest that survival using the "snake" 
      graft conduit is competitive with that observed using the internal mammary 
      artery.
FAU - Quigley, R L
AU  - Quigley RL
AD  - Department of Surgery, Cardiology Guthrie Clinic Ltd., Sayre, Pennsylvania, USA.
FAU - Dienhart, K J
AU  - Dienhart KJ
FAU - Pelkowski, D J
AU  - Pelkowski DJ
FAU - Evans, L C 2nd
AU  - Evans LC 2nd
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aged
MH  - Anastomosis, Surgical
MH  - Coronary Artery Bypass/*methods/mortality
MH  - Coronary Disease/mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Internal Mammary-Coronary Artery Anastomosis/mortality
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/mortality
MH  - Saphenous Vein/*transplantation
MH  - Time Factors
EDAT- 1999/01/19 03:03
MHDA- 2001/03/28 10:01
CRDT- 1999/01/19 03:03
PHST- 1999/01/19 03:03 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1999/01/19 03:03 [entrez]
AID - 10.1111/j.1540-8191.1998.tb01048.x [doi]
PST - ppublish
SO  - J Card Surg. 1998 Jan;13(1):18-23. doi: 10.1111/j.1540-8191.1998.tb01048.x.