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Mario Gaudino
Francesco Alessandrini
Claudio Pragliola
Nicola Luciani
Giuseppe Nasso
Giovanni Guarini
Gianfederico Possati
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Right arrow Coronary disease

J Thorac Cardiovasc Surg 2004;127:1139-1144
© 2004 The American Association for Thoracic Surgery

Surgery for acquired cardiovascular disease

Composite Y internal thoracic artery–saphenous vein grafts: Short-term angiographic results and vasoreactive profile

Mario Gaudino, MDa,*, Francesco Alessandrini, MDa, Claudio Pragliola, MDa, Nicola Luciani, MDa, Carlo Trani, MDb, Francesco Burzotta, MDb, Fabiana Girola, MDa, Giuseppe Nasso, MDa, Giovanni Guarini, MDa, Gianfederico Possati, MDa

a Department of Cardiac Surgery, Catholic University, Rome, Italy
b Department of Cardiology, Catholic University, Rome, Italy

Received for publication May 13, 2003; revisions received June 27, 2003; accepted for publication July 7, 2003.

* Address for reprints: Mario Gaudino, MD, Divisione di Cardiochirurgia, Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy
mgaudino{at}tiscali.it

BACKGROUND: The angiographic patency of composite Y internal thoracic artery–saphenous vein grafts has not been investigated in detail.

METHODS: Twenty-five patients who received composite Y internal thoracic artery–saphenous vein grafts had control angiography and vasoactive challenges with serotonin, acetylcholine, and isosorbide dinitrate at a mean of 2.5 ± 1.2 years after surgery.

RESULTS: The perfect patency rate of composite Y internal thoracic artery–saphenous vein grafts was 72% (18/25). The distal portion of the internal thoracic artery was stringed in 4 patients and occluded in 2. The saphenous branch of the composite Y internal thoracic artery–saphenous vein grafts was found patent in all patients except 1. No failures were reported in the proximal tract of the internal thoracic artery. The distal tract of the internal thoracic artery showed reduced capacity of endothelium-mediated relaxation.

CONCLUSION: The short-term patency of composite Y internal thoracic artery–saphenous vein grafts is suboptimal and markedly influenced by distal runoff and native flow competition.




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