Effect of different surgical strategies on bypass conduits lesions of postoperation

doi:10.3969/j.issn.1672-5301.2017.11.006

Abstract：Objective To analyze the characteristics of bypass conduits and to investigate the influence of different surgical strategies on bypass conduits lesions of postoperation.Methods The clinical data of 126 postoperative patients with recurrent myocardial ischemia and underwent coronary angiography in our hospital from October 2014 to October 2016 were collected.The bypass conduits (angiography showed stenosis 75％ or a "line like sign") in 80 cases and aggravation of native coronary artery lesions (not bypass coronary artery stenosis from less than 75％ increased to more than 75％) in 46 cases.259 vessels and anastomosis in patients with vascular disease in 80 cases were evaluated,including 140 single-bridge and 119 sequential-bridge.An average of 3.2 bridge vessels per patient,which include 72 left internal mammary arteries,8 left radial arteries,3 right radial arteries and 176 great saphenous vein bridge.Results (1)80 cases were the lesion of the bypass conduits,the constituent ratio was 63.5％,and the severity of coronary artery lesion was aggravate in 46 cases,the constituent ratio was 36.5％.(2)The target vessel diameter over 1.5 mm and diameter less than 1.5 mm graft disease rates were 22.9％ and 42.9％,the difference was statistically significant (P＜0.05).(3)Single-bridge and sequential-bridge lesions rates were 25％ and 28.6％,the difference was not statistically significant (P＞0.05).Conclusion The bypass conduits lesion was the main cause of recurrent myocardial ischemia of patients underwent CABG,as far as possible to choose the target vessel diameter anastomosis above 1.5 mm and the sequential anastomosis did not increase the rate of bypass conduits lesions.