Analysis Of Long-term Patency Rate Of Different Bridging Vascular Grafts In Coronary Artery Bypass Grafting

ObjectiveThrough retrospective analysis,the long-term effect of three kinds of bridge vascular graft,such as artery,vein and artery-vein mixed bridge,in coronary artery bypass grafting(CABG)was studied.MethodsThis study is a retrospective study.From January 1998 to October 2013,146 patients who received CABG treatment with left trunk and multi-vessel lesions and SYNTEX score ≥ 33 in our hospital were divided into three groups according to the type of bridge vascular graft:arterial bridge group(n = 29).There were 17 cases of LIMA RA and 12 cases of BIMA.There were 69 cases of venous bridge group,all of which were SVG;mixed bridge group(48 cases),including 17 cases of LIMA RA SVG,26 cases of,LIMA SVG and 5 cases of,RA SVG.Through coronary CTA and coronary angiography,etc.Follow-up was performed on postoperative patients,including 86 patients with follow-up time of more than 5 years,and average follow-up time(7.6±2.5)years.Cumulative review of bridge blood vessel:LIMA 84 root,RA 39 root,SVG 186 root.Univariate analysis,rank sum test,χ2 test and t test were used to analyze and compare the general data before operation,intraoperative data and postoperative data.ResultsGeneral information:The age of arterial bridge group was 62.8±7.3.The age of venous bridge group was slightly older than that of mixed bridge group,but there was no significant difference between the two groups(p>0.05).There were 11 females in Arterial Bridge group,accounting for 38.0%of the total,with the highest percentage.The percentage of hypertension patients in arterial bridge group was 51.7%,and the results were not statistically significant(p>0.05).Other factors,such as smoking history,abnormal lipid metabolism of diabetes mellitus,NYHA grade and so on,had no statistical significance(p>0.05).Intraoperative data:The number of arterial bridged vessels(2.58±0.88)was significantly lower than that of mixed(3.28±0.76)and venous bridge(3.62±0.70)groups(p<0.05).Post-operative data:The duration of mechanical ventilation in the arterial bridge group was lower than that in the mixed bridge group and the venous bridge group[(46.3±3.78)vs(90.3±4.78),p<0.05;(46.3±3.78)vs(86.3±3.68),p<0.05)].The stay time of ICU in arterial bridge group was lower than that in mixed bridge group and venous bridge group[(46.3±3.78)vs(90.3±4.78),p<0.05;(46.3 ±3.78)vs(86.3±3.68),p<0.05)].The proportion of exercise was higher in arterial bridge group(86.6%),venous bridge group(69.0%)and mixed bridge group(79.3%).p<0.05.There was no significant difference in overall survival rate,AP remission rate and non-MACE incidence between 1 and 3 years after CABG(p>0.05).Compared with the overall survival curve over 5 years,the arterial bridge group showed superiority(p<0.05);AP),and there was no significant difference among the three groups(p>0.05).Compared with the time curve without MACE,the arterial bridge group was better than the venous bridge group and the mixed bridge group(p<0.05);Imaging results:no lesions were detected in LIMA.The total patency ratio of arterial bridge group was better than that of venous bridge group and mixed bridge group(92.9%,76.0%,87.0%,p<0.05).The target vessel revascularization rate(TVR)in arterial bridge group was lower than that in venous bridge group and mixed vascular bridge group(total artery group 0,total vein group 11.6%,mixed bridge group 5.3%;p<0.05).There was no statistical difference in the patency rate of artery,vein and mixed bridge group 1 year after CABG;3 years(middle stage)patency rate of arterial bridge It was higher in group A than that in group B and B(100%in arterial bridge group,81.7%in vein bridge group,93%in mixed bridge group,and 0.051%in mixed bridge group).The patency rate of arterial bridge group was higher than that of venous bridge gro up(98.0%),venous bridge group(73.3%)and mixed bridge group(87.4%)(p<0.05).The time curves of patency of artery,vein and mixed bridge group were better than those of venous bridge group and mixed bridge group(p<0.05).Conclusions1.Arterial bridge,vein bridge and mixed bridge can effectively improve the curative effect of patients with left trunk and polyangiopathy.There is no significant difference between the three groups after operation and the incidence of complications2.The arterial bridge group has a higher long-term patency rate compared with the vein and the hybrid bridge group.