The Risk Factors Of Mid And Long-term Patency Rate For Grafts After Off-pump Coronary Artery Bypass Grafting

Objective:To analyze the mid and long-term patency rate for grafts after off-pump coronary artery bypass grafting and the risk factors of patency rate.Methods:Seven thousand five hundred and twenty-one patients were underwent CABG in Tianjin Chest Hospital, one hundred and thirteen cases underwent OPCAB were followed up, among them, fifty-four cases were followed up by searching the coronary artery angiography and fifty-nine cases were followed up by searching dual Source CT. The patients were70males and43females with a mean age of63.02±8.83years at the time of surgery. Preoperative coronary angiography revealed one-vessel disease in5patients, two-vessel disease in13patients, three-vessel disease in95patients, and left main coronary artery disease with or without peripheral coronary artery disease in32patients.Eighty-six patients had high blood pressure,42patents had diabetes mellitus,26patents had hyperlipidemia,36patents had old Myocardial Infarction,14patents had old cerebral infarction,40patents had a smoke by now and31patients were older than70years. The mean following up period was27.01±18.59months and the average number of distal anastomoses per patient was2.96±0.86. Internal thoracic arteries (ITA) were used in75and saphenous veins were used in260.Calculate the patency rate for arterial graft and the patency rate for saphenous vein grafts respectively and analyse the risk factors of mid and long-term patency rate for grafts after off-pump coronary artery bypass grafting.Results:The patency rate of all grafts after coronary artery bypass grafting was83.0%; and98.0%for internal thoracic arteries; the one year and five years patency rate was98.6%and88.5%for ITA; the patency rate was78.1%for saphenous vein grafts, and the one year and five years patency rate was85.9%and61.3%for saphenous vein grafts; the patency rate with angina group was78.9%and92.2%for angina-free group, there were differences between the two groups (P=0.007.Conclusion:The ITA grafts have a better long-term patency than saphenous vein grafts; The average number of distal anastomoses and the female is closely related to the patency rate for grafts after CABG; Graft lesion after CABG is an important factor leading to postoperative recurrent angina pectoris.