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Longterm Results of Saphenous Vein Grafts after Coronary Artery Bypass Grafting:Late stenosis or closure and its mode of progression Hitoshi Anzai 1 , Nobuyuki Komiyama 1 , Yutarou Nishi 1 , Mieko Kobayashi 1 , Takashi Iwase 1 , Sugao Ishiwata 1 , Yoshiki Yanagishita 1 , Shinichirou Nishiyama 1 , Shigemoto Nakanishi 1 , Akira Seki 1 , Yoshihiro Naruse 2 , Haruo Makuuchi 2 1Division of Cardiovascular Center, Toranomon Hospital 2Division of Cardiovascular Surgery, Toranomon Hospital Keyword: 冠動脈造影 , 冠動脈バイパス術 , 伏在静脈グラフト , 粥状硬化 , coronary angioplasty , coronary artery bypass grafting , saphenous vein grafts , atherosclerosis pp.847-853
Published Date 1996/8/15
DOI https://doi.org/10.11477/mf.1404900011
  • Abstract
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To clarify the natural history of saphenous vein grafts (SVGS) used in coronary artery bypass grafting (CABG) , we investigated the follow-up coronary angio-graphy of 442SVGs in 203 patients with CABG perfor-med in the early postoperative period (after about 6 months) and in the late postoperative period (after about 6.8 years). In addition, we evaluated the progres-sion of stenotic lesions by coronary angiography in 183late SVGs performed at least twice during the postoper-ative period.

Results: (1) After 5 years, SVGs became atheros-clerotic resulting in significant stenotic and obstructive lesions. Afterward, the incidence of new lesions tended to increase further. (2) The group of patients who were examined by additional angiography because of the development of the signs of new ischemia had a higher incidence of additional significant and obstruc-tive lesions as compared with the patients who had no signs of new ischemia. (3) About a half of moderate (50%≦,<75%) stenotic lesions of the late SVGs pro-gressed to severe stenotic lesions. About 70% of over 75% significant stenotic lesions of the late SVGs became more significant and about a half of them reached total occlusion. (4) There is some evidence that minor stenotic lesions became significant after only one or two years.

Conclusions: We must pay careful attention to the occurrence of new ischemia after CABG. If moderate stenotic lesions occur, we should perform coronary angiography once a year and always consider the pos-sible need for revascularization therapy including per-cutaneous coronary angioplasty.


Copyright © 1996, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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