Unfavourable results with multiple distal targets for SVG

Unfavourable results with multiple distal targets for SVG

Unfavourable results with multiple distal targets for SVG: Saphenous vein is one of the commonest conduits being used for coronary artery bypass graft surgery (CABG), though it is well known that it is inferior to left internal mammary artery grafts. Saphenous veins grafts are used with single distal targets as well as with multiple distal targets. Rajendra H Mehta, T Bruce Ferguson, Renato D Lopes, Gail E Hafley, Michael J Mack, Nicholas T Kouchoukos, C Michael Gibson, Robert A Harrington, Robert M Califf, Eric D Peterson and John H Alexander, the Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV Investigators [1] studied the one year failure rates of saphenous vein grafts (SVG) (defined as seventy five percent or more of angiographic stenosis) and five year clinical event rates (death, myocardial infarction and revascularization and their combinations). Of the three thousand odd patients, more than one third had one or more SVGs during CABG. They found that vein graft failure rates were higher for those with multiple distal targets than for SVGs with single distal target. The five year cardiac event rates were also higher in the former. The authors conclude that until further study reports are available on this aspect, saphenous vein grafts with single distal target should be encouraged.

Reference

1. Rajendra H Mehta, T Bruce Ferguson, Renato D Lopes, Gail E Hafley, Michael J Mack, Nicholas T Kouchoukos, C Michael Gibson, Robert A Harrington, Robert M Califf, Eric D Peterson, John H Alexander, Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV Investigators. Saphenous Vein Grafts With Multiple Versus Single Distal Targets in Patients Undergoing Coronary Artery Bypass Surgery One-Year Graft Failure and Five-Year Outcomes From the Project of Ex-Vivo Vein Graft Engineering via Transfection (PREVENT) IV Trial. Circulation. 2011 Jul 19;124(3):280-8.