PATENCY OF CRYOPRESERVED SAPHENOUS-VEIN GRAFTS AS CONDUITS FOR CORONARY-ARTERY BYPASS-SURGERY

Study objective: To determine the angiographic patency of cryopreserve d saphenous vein grafts used as conduits during coronary artery bypass surgery and whether this is affected by postoperative immunosuppressi ve therapy. Design ana setting: A retrospective review of medical reco rds and coronary angiograms of patients at a university hospital. Pati ents: Eleven patients undergoing 12 coronary artery bypass operations during which a total of 26 distal coronary anastomoses were created us ing cryopreserved vein grafts. Measurements: Eight postoperative coron ary angiograms were performed in 10 patients surviving longer than 1 w eek. All angiograms were performed on the basis of symptoms of suspect ed myocardial ischemia. Angiographic results, postoperative anticoagul ation, and therapy with immunosuppressive agents were analyzed.Results : Seventeen cryopreserved vein grafts were studied; one (6%) was paten t, 12 (71%) were occluded, and 4 (23%) were stenosed. In patients trea ted with azathioprine, seven of the eight cryopreserved vein grafts we re occluded, In patients not receiving immunosuppression, five were oc cluded, three were stenosed, and one was patent. Bu internal mammary g rafts were widely patent. Conclusion: Cryopreserved vein grafts have a poor angiographic patency which did not appear to be affected by immu nosuppressive therapy with azathioprine, The use of this graft should be restricted and alternative arterial conduits utilized.