European Journal of Cardio-Thoracic Surgery, Vol 10, 129-140, Copyright © 1996 by European Association for Cardio-thoracic Surgery
Arterial and venous conduits for coronary artery bypass. A current review
GJ Cooper, MJ Underwood and PB Deverall
Cardiothoracic Unit, Guy's Hospital, London, UK.
Poor long-term patency of saphenous vein grafts limits the long-term
success of the coronary artery bypass operation. If this is to be improved,
either measures that increase the patency of saphenous vein grafts or
alternative conduits are required. The benefits of using the left internal
mammary artery as a pedicled graft to the left anterior descending coronary
artery have prompted increasing use of arterial grafts to further improve
outcome. Concurrently advances in the understanding of the pathological
processes underlying saphenous vein graft occlusion raise the possibility
of improving vein graft patency. In this paper we review the problem of
vein graft occlusion and possible solutions, the theoretical benefits of
arterial grafts and the clinical results associated with their use.