Comparative study in graft patency of individual and sequential grafting as coronary bypass

We analyzed the graft patency rates of the individual saphenous vein graft (SVG) group and those of the sequential SVG group. In the individual SVG group, 184 SVGs were anastomosed to 184 coronary arteries. Twenty-six SVGs were used sequentially to 52 coronary arteries in the sequential group. The patency rates of all the SVGs in both groups showed no significant differences. The patency of left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA) and diagonal branch (Dx) was 96%, 67%, 90% and 63% respectively in the individual SVG group. In the sequential SVG group, the patency rates of LCX (95%) were much higher than those (67%) of the individual SVG group (p < 0.05). The patency rates of side-to-side anastomoses (SSAs) were 92% and those of the distal end-to-side anastomoses (ESAs) were 96% in the sequential SVG group. There were no significant differences between SSAs and ESAs. While, the patency rates of SSAs-Dx, ESAs-Dx, SSAs-LCX and ESAs-LCX were 89%, 100%, 100%, and 93% respectively in the sequential SVG group. There were no significant differences between two groups. These results showed that the sequential grafting is useful and effective for LCX coronary arteries in coronary artery bypass surgery. In conclusion, it seems that in LCX coronary arteries, the patency rates obtained by the sequential SVG technique are better than those obtained by using the individual SVG technique.