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J Thorac Cardiovasc Surg 2001;122:687-690
© 2001 The American Association for Thoracic Surgery

Surgery for Aquired Cardiovascular Disease (ACD)

Composite lengthened arterial conduits: Long-term angiographic results of an uncommon surgical strategy

From the Department of Cardiac Surgery, G. D&'Annunzio University, Chieti, Italy.

Received for publication Jan 8, 2001. Revisions requested Feb 26, 2001; revisions received March 26, 2001. Accepted for publication March 28, 2001. Address for reprints: Antonio Maria Calafiore, MD, G. D&'Annunzio University, Department of Cardiac Surgery, S. Camillo de&' Lellis Hospital, Via C. Forlanini, 50, 66100 Chieti, Italy (E-mail: calafiore@ unich.it).

Abstract

Background: We sought to evaluate the long-term patency rate of composite lengthened conduits.
Methods and Results: From December 1991 to April 2000, 43 patients had a composite lengthened arterial conduit. There was a mean of 2.83 ± 1.23 anastomoses per patient. No 30-day mortality occurred. Five patients died from 3 to 84 months after the operation (mean, 38.6 ± 34.6 months). After a mean follow-up of 57.0 ± 32.3 months (range, 3-99 months), all the survivors are asymptomatic. The only cardiac major events recorded were 2 (4.6%) late acute myocardial infarctions in the patients who died. Eight-year survival and event-free survival were both 80.4% ± 9.1% (range, 3%-93%). In the early period (13.5 ± 4.8 days) in 26 patients, 26 arterial composite lengthened conduits and 37 distal anastomoses had postoperative angiographic control; all the anastomoses were rates as grade A, according to Fitzgibbon classification. In the late period (29 ± 30 months) in 23 patients, 23 arterial composite lengthened conduits and 34 distal anastomoses were checked; the patency rate was 22 (95.6%) of 23 for the composite lengthened conduits and 33 (97%) of 34 for the distal anastomoses.
Conclusions: In particular situations, when the length of an arterial conduit is not enough to allow a correct use of the graft, lengthening of an arterial conduit can be a safe and effective technique.

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