Composite lengthened arterial conduits: Long-term angiographic results of an uncommon surgical strategy

Background: We sought to evaluate the long-term patency rate of composite l engthened conduits. Methods and Results: From December 1991 to April 2000, 43 patients had a co mposite lengthened arterial conduit. There was a mean of 2.83 +/- 1.23 anas tomoses per patient. No 30-day mortality occurred. Five patients died from 3 to 84 months after the operation (mean, 38.6 +/- 34.6 months). After a me an follow-up of 57.0 +/- 32.3 months (range, 3-99 months), all the survivor s are asymptomatic. The only cardiac major events recorded were 2 (4.6%) la te acute myocardial infarctions in the patients who died. Eight-year surviv al and event-free survival were both 80.4% +/- 9.1% (range, 3%-93%). In the early period (13.5 +/- 4.8 days) in 26 patients, 26 arterial composite len gthened conduits and 37 distal anastomoses had postoperative angiographic c ontrol; all the anastomoses were rates as grade A, according to Fitzgibbon classification. In the late period (29 +/- 30 months) in 23 patients, 23 ar terial composite lengthened conduits and 34 distal anastomoses were checked ; the patency rate was 22 (95.6%) of 23 for the composite lengthened condui ts and 33 (97%) of 34 for the distal anastomoses. Conclusions: In particular situations, when the length of an arterial condu it is not enough to allow a correct use of the graft, lengthening of an art erial conduit can be a safe and effective technique.