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Articles

Title: Univariate analysis of the influence of conduit type upon the long-term results of surgical treatment of ischaemic heart disease in patients under 40 years of age

Author:
Przemysław Trzeciak, Marian Zembala
Type:
Original articles
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2002
Volume:
4
Number:
3
Start page:
227
Final page:
232
ISSN:
1507-5540
Keywords:
coronary artery bypass graft surgery, patients under 40 years of age, arterial conduit
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Introduction: Coronary artery bypass graft surgery is valuable therapy for angina in patients with ischaemic heart disease. Aim: The aim of our study was an univariate analysis of the used conduit type upon the long-term results of surgical revascularization in patients under 40 years of age. Material and methods: We analyzed 94 patients who had CABG under 40 years of age in Silesian Center of Heart Disease from January 1986 through December 1997. The mean age was 37.0±2.12 years. The mean length offollow-upwas62.36±42.05 months. Venousconduitsonlywere used in 28 (29.8%) patients, only arterial in 14 (14.9%), and 52 (55.3%) patients obtained arterial grafts combined with vein grafts. Results: In the group of 94 patients, 64(68.1%) werefreeof angina, 19(20.2%) had the recurrence of symp-toms, and 11 (11.7%) died during follow-up period. The recurrence of angina was significantlyhigheramong 22Z patients with only saphenous vein conduits compared to those with only arterial grafts (p=0.0076), and patients with arterial conduits in association with saphenous vein grafts (p=0.0006). There was no significant difference in the recurrence of symptoms between patients who obtained only arterial grafts in comparison to patients who had arterial and saphenous vein conduits (p=0.3411). There was a significant difference in the recurrence of angina after the comparison of the two groups: patients who received only saphenous ve-in grafts with patients who received only arterial grafts or at least one IMA bypass combined with saphenous vein conduits (p<0.0001). Patients who obtained only venous grafts had higher mortality during long-term follow-up in comparison to patients who received at least one internal mammary artery conduit (p=0.0002). Conclusion: 1. Arterial grafts are superior to vein grafts in alleviating anginal symptoms and preventing mortality during follow-up period in patients under 40 years of age. 2. Young patients who obtained at least one IMA graft had a lower ratę of recurrent angina and death after surgery.