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J Thorac Cardiovasc Surg 1996;111:399-407
© 1996 Mosby, Inc.


SURGERY FOR ACQUIRED HEART DISEASE

EFFECTS OF COMPETITIVE BLOOD FLOW ON ARTERIAL GRAFT PATENCY AND DIAMETERMEDIUM-TERM POSTOPERATIVE FOLLOW-UP

Hideki Hashimoto, MD, MPHa, Takaaki Isshiki, MD, FACCb, Yuji Ikari, MDa, Kazuhiro Hara, MDa, Fumihiko Saeki, MDa, Tsutomu Tamura, MDa, Tetsu Yamaguchi, MDc, Hisayoshi Suma, MDd


Tokyo, Japan

Received for publication Jan. 19, 1995. Accepted for publication May 5, 1995. Address for reprints: Hideki Hashimoto, MD, MPH, 16 Winter St., #3, Somerville, MA 02144.

Abstract

To identify predictors of arterial graft patency, we followed up 30 internal thoracic arterial grafts and 23 right gastroepiploic arterial grafts in situ with patency documented during postoperative angiography. After 24 months of follow–up on average, repeat angiography detected that one internal thoracic artery and two gastroepiploic arteries were anatomically occluded and that the other three gastroepiploic arteries were nonfunctioning. The logistic regression model identified a relationship between graft patency and competitive flow, which was detected as stenosis in the recipient coronary arteries (coefficients, p < 0.05; model, Hosmer–Lemeshow{chi}2 statistic 3.59, p = 0.89). The linear regression model demonstrated that changes in graft luminal diameter correlated with competitive flow (p < 0.01), smoking history (p < 0.05), and type of arterial grafts (p < 0.001) (R2 = 0.40, adjusted R2 = 0.36). The findings suggest a temporal relationship between competitive flow and prognosis of arterial graft. (J THORACCARDIOVASCSURG1996;111:399-407)




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