Coronary “open” endarterectomy and reconstruction: short- and long-term results of the revascularization with saphenous vein versus IMA-graft

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Abstract
From June 1984 to December 1990, 96 patients underwent "open" coronaryendarterectomy and reconstruction. In 50 patients (group 1), a saphenousvein (SV) graft was used to reconstruct and bypass 54 coronary vessels. In46 patients (group 2), 46 coronary vessels were reconstructed with an SVpatch and then bypassed with the internal mammary artery (IMA):Seventy-four LAD coronary arteries (36 in group 1 and 38 in group 2) weretreated with these procedures. Operative mortality was 8% in group 1 and2.1% in group 2. Five patients (10%) in group 1 and 1 patient (2.1%) ingroup 2 developed perioperative myocardial infarction. The earlypostoperative patency of the reconstructed vessels was 84.6% in group 1 and92.5% in group 2. Angiographic controls were performed between 30 and 36months after operation in 18 patients (72%) of group 1 and in 16 patients(69%) of group 2 with patency rates of 66.7% and 81.5%, respectively. Afurther angiographic study performed between 54 and 60 months afteroperation of 9/22 patients of group 1 and 5/9 patients of group 2 did notshow any additional closure of the endarterectomized vessels. Three- and 5-year survival analyzed by the Kaplan-Meier method was 79.6% and 69.7%,respectively, in group 1 and 86.8% for both the 3- and 5-year survival ingroup 2. After a mean follow-up of 51.0 and 35.5 months, 62.8% of thesurviving patients of group 1 and 75.6% of group 2 wereasymptomatic.(ABSTRACT TRUNCATED AT 250 WORDS)

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