Use of the great saphenous vein in place of left internal mammal artery
in unconventional cases for left anterior descending artery
revascularization
Abstract
Introduction: For some patients whose LIMA cannot be used, surgeons have
to choose other conduit materials to revascularize the LAD. This study
was to explore the differences between SVG and LIMA used for LAD in
terms of parameters measured by transit-time flow measurement (TTFM) and
the early graft patency. Methods: A total of 374 patients who underwent
CABG were included in this study. According to the strategy of the left
descending artery (LAD) revascularization, 374 patients were assigned to
two groups: a left internal mammal artery (LIMA)group(n=332) and a great
saphenous vein (SVG) group (n=42). Results: Before propensity
Score-Matched, compared with the LIMA-LAD group, the SVG-LAD group had a
significantly higher MGF(37.85±23.28 vs 29.70±20.97ml/min, P=0.021),but
a lower PI value (2.12±0.68 vs 2.65±1.01,P<0.001).There was no
significant difference between the two groups in terms of DF(P>0.05).
After 1:2 propensity Score-Matched, there were 114 patients were
included (SVG-LAD 38, LIMA-LAD 76), there was no difference in the
baseline data between the two groups. Compared with the LIMA-LAD group,
the SVG-LAD group also had a lower PI value (2.07±0.63 vs
2.74±1.02,P<0.001),and also a higher MGF(37.27±24.31 vs
29.92±21.92ml/min),but there was no statistically difference(P=0.109).
There was no significant difference between the two groups in DF
(P>0.05). There was no difference among the two groups in patency
rate(P=0.405). Conclusion: SVG-LAD has a higher MGF and a lower PI value
than LIMA-LAD before PSM but just has a lower PI value than LIMA-LAD
after PSM. There was no difference among the two groups in early patency
rate.