| Autor: |
Grondin, Claude M., Campeau, Lucien, Lespérance, Jacques, Solymoss, B. Charles, Vouhé, Pascal, Castonguay, Yves R., Meere, Claude, Bourassa, Martial G. |
| Zdroj: |
Journal of Thoracic and Cardiovascular Surgery; January 1979, Vol. 77 Issue: 1 p24-31, 8p |
| Abstrakt: |
One hundred ten patients underwent angiographic evaluation 6 years after aorta-coronary artery vein grafting. All had been subjected to one postoperative study earlier, and 94 had had two. Of the 158 patent grafts at 6 years, 20 showed changes which appeared different from those noted on previous studies. These changes were of five types: a large filling defect in eight, a smooth plaque in five, a spur or diaphragm-like lesion in four, a conventional circumferential stenosis in two, and an irregular graft contour in one. Several grafts showed multiple lesions: Ten had irregular thickening, four had localized dilatation, and two had fibrous plaque. Eleven of the 20 grafts showed a narrowing of 50 percent of their lumen or greater, including five whose narrowing was 80 percent or more. Four grafts recovered at reoperation showed gross and histologic evidence of overt atherosclerosis. Review of the coronary arteriograms revealed that 56 patients had progression of coronary artery disease (CAD) in nongrafted arteries and 53 did not. Seventeen of the 56 patients with progression of CAD were among the 20 patients with late graft narrowings, whereas only two of the 53 patients without such progression had late graft changes (p < 0.0005). Of the 20 patients with graft narrowing at 1 year, eight had progression of CAD at 6 years, whereas 13 of 14 patients with late graft narrowings had progression of CAD (p < 0.005). Serum levels of cholesterol and triglycerides were comparable in all groups of patients whether or not the patients had progression of CAD, normal appearing grafts, or narrowing and occlusion of grafts on any of the postoperative studies. |
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