Roentgeno-morphological characteristics of graft changes after coronary artery bypass surgery

Limited life span of aorto-coronary conduits is a main cause of recurrence of symptoms of ischemic heart disease after coronary artery bypass grafting (CABG). The aim of this study was to investigate roentgenological morpholo gy of grafts in various periods of time after CABG. Material. 188 patients subjected to CABG with total numbers of mammary artery and venous grafts 12 3 and 375, respectively. Patients were divided into 4 groups depending on t iming of assessment of graft patency after CABG by angiography (group 1 - d uring first, 2 - second year, 3 - from 2 to 5, 4 - in more than 5 years). R esults. Proportion of failed mammary arterial grafts was similar in patient s of all groups (3,2, 5, 3 and 5,3% in groups 1,2,3, and 4, respectively). In all periods after CABG causes of graft failures were total occlusions or defects of distal anastomoses. Angiographical sings of atherosclerosis in arterial conduits were never observed. Proportions of failed venous grafts were 20,3, 26,5. 33,6 and 41,8% in groups 1,2,3, and 4, respectively. In gr oup 1 failures of venous grafts were mainly due to total occlusions. In lat er periods after CABG (groups 2,3 and 4) numbers of deficient grafts increa sed at the account of both total occlusions and stenoses with roentgenologi cal morphology typical for atherosclerosis. Conclusion. Contrary to mammary arterial conduits proportion of failed venous grafts increased with time. Difference in roentgenological appearance of failed venous grafts in variou s periods of time after CABG could represent different pathological process es in these grafts: thrombosis and intimal hyperplasia in early, formation of atherosclerotic lesions in remote period after CABG.