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(Chest. 1995;108:725-729.)
© 1995 American College of Chest Physicians

Patency of Cryopreserved Saphenous Vein Grafts as Conduits for Coronary Artery Bypass Surgery

Robert A. Iaffaldano MD1; Bruce E. Lewis MD1; Sarah A. Johnson MD1; Roque Piffare MD1; and Thomas L. McKieman MD1

1 From Loyola University Medical Center, Departments of Cardiology and Cardiovascular Surgery, Maywood, Ill.

Study objective: To determine the angiographic patency of cryopreserved saphenous vein grafts used as conduits during coronary artery bypass surgery and whether this is affected by postoperative immunosuppressive therapy.

Design and setting: A retrospective review of medical records and coronary angiograms of patients at a university hospital.

Patients: Eleven patients undergoing 12 coronary artery bypass operations during which a total of 26 distal coronary anastomoses were created using cryopreserved vein grafts.

Measurements: Eight postoperative coronary angiograms were performed in 10 patients surviving longer than 1 week. All angiograms were performed on the basis of symptoms of suspected myocardial ischemia. Angiographic results, postoperative anticoagulation, and therapy with immunosuppressive agents were analyzed.

Results: Seventeen cryopreserved vein grafts were studied; one (6%) was patent, 12 (71%) were occluded, and 4 (23%) were stenosed. In patients treated with azathioprine, seven of the eight cryopreserved vein grafts were occluded. In patients not receiving immunosuppression, five were occluded, three were stenosed, and one was patent. All internal mammary grafts were widely patent.

Conclusion: Cryopreserved vein grafts have a poor angiographic patency which did not appear to be affected by immunosuppressive therapy with azathioprine. The use of this graft should be restricted and alternative arterial conduits utilized.

Key Words: coronary artery bypass • cryopreservation • immunosuppression

Submitted on July 22, 1994
Accepted on January 15, 1995




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