Thirty-year patency of a coronary sequential venous bypass graft

Thirty-year patency of a coronary sequential venous bypass graft

Authors

  • Alberto Molardi Azienda Ospedaliero-Universitaria di Parma
  • Francesco Nicolini Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy
  • Filippo Benassi Azienda Ospedaliero-Universitaria di Parma
  • Alan Gallingani Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy
  • Tiziano Gherli Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy
  • Igino Spaggiari Azienda Ospedaliero-Universitaria di Parma

Keywords:

Coronary artery disease, coronary artery bypass grafting, surgery

Abstract

The optimal conduit of second choice in surgical coronary revascularization  remains a matter of debate. Radial artery grafts are believed to have a better patency rate than the saphenous vein grafts, although no conclusive results have been reported. This report describes the late result of a coronary revascularization with sequential venous bypass performed 30 years earlier.

Methods

An 80-year-old woman was admitted for dyspnoea on exertion and recent-onset angina due to severe aortic valve stenosis. Thirty years earlier, the patient had undergone revascularization with coronary bypass grafting performed using a sequential saphenous vein graft anastomosed on first diagonal branch and on left anterior descending coronary artery. Coronary angiography showed the occlusion of the native left anterior descending artery and the good patency of the previous described sequential vein graft.

Results

Surgical inspection confirmed the patency and the soft pliability of the venous graft and the surgeon decided to do not replace the previous graft with a pedicled LIMA (Left Internal Mammary Artery) graft.   The patient underwent 21-mm biological Edwards Perimount Magna Ease prosthesis implantation. Postoperative course was uneventful and the patient was discharged on the seventh day after surgery.

Conclusions

This case report demonstrated the potential extreme long-term patency of a sequential saphenous vein graft in coronary bypass surgery, raising the question if vein grafts should be really considered the conduits of last resort for coronary artery bypass surgery. Long-term follow-up of randomized trials comparing radial artery versus saphenous vein grafts are warranted in order to give conclusive  answers to this ongoing debate.

Author Biographies

Alberto Molardi, Azienda Ospedaliero-Universitaria di Parma

Cardio-nephro-pulmonary Departement, Complex Unit of Cardiac Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

Francesco Nicolini, Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy

Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy

Filippo Benassi, Azienda Ospedaliero-Universitaria di Parma

Cardio-nephro-pulmonary Departement, Complex Unit of Cardiac Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

Alan Gallingani, Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy

Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy

Tiziano Gherli, Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy

Department of Clinical and Experimental Medicine, Section of Heart Surgery, University of Parma, Parma, Italy

Igino Spaggiari, Azienda Ospedaliero-Universitaria di Parma

Cardio-nephro-pulmonary Departement, Complex Unit of Cardiac Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

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Published

09-05-2014

How to Cite

1.
Molardi A, Nicolini F, Benassi F, Gallingani A, Gherli T, Spaggiari I. Thirty-year patency of a coronary sequential venous bypass graft. Acta Biomed [Internet]. 2014 May 9 [cited 2024 Jul. 16];85(1):57-9. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/3383