Differences in adaptation to growth of children between internal thoracic artery and saphenous vein coronary bypass grafts

Background. It is not known how the internal thoracic artery (ITA) and saph enous vein graft (SVG) adapts to somatic growth of pediatric patients who u nderwent coronary artery bypass grafting (CABG), Methods, Twenty-two ITAs and 6 SVGs in 17 patients who underwent at least t hree postoperative catheterizations with biplanar cineangiography and follo wed for a minimum of 5 years were evaluated. We evaluated the length, diame ter and curvature of the grafts by cineangiographies which were performed a t 1 month, 1 year, 5 years and more than 5 years postoperatively, Results. The length of the ITA (1-month: 117 +/- 31 mm, 1-year: 134 +/- 32 mm, 5-years: 146 +/- 28 mm, and >5-years: 155 +/- 34 mm, p=0.032) and diame ter of the ITA (1.4 +/-0.4 mm, 2.0 +/-0.7 mm, 2.3 +/-0.6 mm and 2.6 +/-0.6 nun, p<0.0001) significantly increased over time, but neither the length no r diameter of the SVG length: 121<plus/minus>33 mm, 119 +/- 29 nun, 119 +/- 25 mm and 126 +/-1 mm, p=0.9907; diameter: 4.1 +/-1.0 mm, 3.9 +/-0.7 mn, 4 .0 +/-0.8 mm and 3.3 +/-0.4 mm, p=0.5784) increased. Although the ITA exhib ited no change in curvature over time (1 month: 1.15 +/-0.07, late: 1.15 +/ -0.07, p=0.8490), the curvature of the SVG significantly decreased over tim e (1 month: 1.42 +/-0.19 and late: 1.25 +/-0.16, p=0.0277), The percent seg mental length of ITAs were changed little from early to late after CABG (1 month: proximal: 33.7 +/-7.0%, middle: 33.3 +/-7.9% and distal: 32.9 +/-7.9 %, vs late: 34.3 +/-7.2%, 33.2 +/- 17.9% and 32.5 +/-7.9%, p=0.937), Conclusions. ITAs grow in proportion to somatic growth while SVGs course in a more Linear fashion in adapting to patient growth.