Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
General Thoracic and Cardiovascular Surgery
Erschienen in: General Thoracic and Cardiovascular Surgery 10/2017

09.08.2017 | Current Topics Review Article

Current trends in selection of conduits for coronary artery bypass grafting

verfasst von: Thierry Carrel, Bernhard Winkler

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

Abstract

The procedure of coronary artery bypass grafting continues to be the “gold standard” for patients with multivessel coronary artery disease and left main stenosis due to favourable long-term and consistent outcomes despite the advent of new generations of stents. But the targeted better long-term outcome of surgical revascularization over percutaneous interventions depends on several variables and aspects; one of them is the choice of conduits used to bypass the stenosed arteries. Coronary artery bypass surgery has been studied and debated for decades and the same applies to the selection of grafts. Current data provide significant benefits for patients who receive full arterial revascularization using both internal thoracic arteries and, if applicable, the radial artery. Unfortunately, the use of multiple arterial grafts is still not performed widely despite the evidence of superiority over multiple saphenous vein grafts that are still the most used grafts in cardiovascular procedures. In this review article, we present current trends and evidences for graft selection and give an overview of controversial data regarding the comparison of the radial artery and saphenous vein. Additionally, few words are spelt on alternative conduits.
Literatur
1.
Costa F, Ariotti S, Valgimigli M, Kolh P, Windecker S, Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Perspectives on the 2014 ESC/EACTS guidelines on myocardial revascularization: 50 years of revascularization: where are we and where are we heading? J Cardiovasc Transl. Res. 2015;8:211–20.CrossRefPubMedPubMedCentral
2.
Jeremias A, Kaul S, Rosengart TK, Gruberg L, Brown DL. The impact of revascularization on mortality in patients with nonacute coronary artery disease. Am J Med. 2009;122:152–61.CrossRefPubMed
3.
Boudriot E, Thiele H, Walther T, Liebetrau C, Boeckstegers P, Pohl T, Reichart B, Mudra H, Beier F, Gansera B, Neumann FJ, Gick M, Zietak T, Desch S, Schuler G, Mohr FW. Randomized comparison of percutaneous coronary intervention with sirolimus-eluting stents vs. coronary artery bypass grafting in unprotected left main stem stenosis. J Am Coll Cardiol. 2011;57:538–45.CrossRefPubMed
4.
5.
Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360:961–72.CrossRefPubMed
6.
Mohr FW, Morice MC, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013;381:629–38.CrossRefPubMed
7.
Loop FD, Lytle BW, Cosgrove DM, et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med. 1986;314:1–6.CrossRefPubMed
8.
Naito Y, Shinoka T, Duncan D, Hibino N, Solomon D, Cleary M, Rathore A, Fein C, Church S, Breuer C. Vascular tissue engineering: towards the next generation vascular grafts. Adv Drug Deliv Rev. 2011;63:312–23.CrossRefPubMed
9.
10.
Desai ND, Naylor CD, Kiss A, et al. Impact of patient and target-vessel characteristics on arterial and venous bypass graft patency: insight from a randomized trial. Circulation. 2007;115:684–91.CrossRefPubMed
11.
Cameron A, Davis KB, Green G, et al. Coronary bypass surgery with internal-thoracic-artery grafts—effects on survival over a 15-year period. N Engl J Med. 1996;334:216–9.CrossRefPubMed
12.
Zulli A, Hare DL, Horrigan M, et al. The resistance of the IMA to atherosclerosis might be associated with its higher eNOS, ACE and ET-A receptor immunoreactivity. Arterioscler Thromb Vasc Biol. 2003;23:1308.CrossRefPubMed
13.
Tennant M, McGeachie JK. Blood vessel structure and function: a brief update on recent advances. Aust N Z J Surg. 1990;60(10):747–53.CrossRefPubMed
14.
Müller-Schweinitzer E, Müller SE, Reineke DC, Kern T, Carrel TP, Eckstein FS, Grapow MT. Reactive oxygen species mediate functional differences in human radial and internal thoracic arteries from smokers. J Vasc Surg. 2010;51:438–44.CrossRefPubMed
15.
Zhou B, Margariti A, Zeng L, Xu Q. Role of histone deacetylases in vascular cell homeostasis and arteriosclerosis. Cardiovasc Res. 2011;90:413–20.CrossRefPubMed
16.
Fitzgibbon GM, Kafka HP, Leach AJ, et al. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5065 grafts related to survival and reoperation in 1388 patients during 25 years. J Am Coll Cardiol. 1996;28:616–26.CrossRefPubMed
17.
Blaas I, Heinz K, Würtinger P, Türkcan A, Tepeköylü C, Grimm M, Doppler C, Danzl K, Messner B, Bernhard D. Vein graft thrombi, a niche for smooth muscle cell colonisation-A hypothesis to explain the asymmetry of intimal hyperplasia. J Thromb Haemost. 2016;14(5):1095–104.
18.
Dion R, Glineur D, Derouck D, et al. Long-term clinical and angiographic follow-up of sequential internal thoracic artery grafting. Eur J Cardiothorac Surg. 2000;17:407–14.CrossRefPubMed
19.
Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol. 2004;44:2149–56.CrossRefPubMed
20.
Cameron A, Davis KG, Green G, Schaff HV. Coronary bypass surgery with internal-thoracic-artery grafts: effects on survival over a 15-year period. N Engl J Med. 1996;33:216–9.CrossRef
21.
Kaul TK, Fields BL, Wyatt DA, Jones CR, Kahn DR. Reoperative coronary artery bypass surgery: early and late results and management in 1300 patients. J Cardiovasc Surg. 1995;36:303–12.
22.
Taggart DP, Altman DG, Gray AM, et al. Randomized trial to compare bilateral vs. single internal mammary coronary artery bypass grafting: 1-year results of the Arterial Revascularization Trial (ART). Eur Heart J. 2010;31:2470–81.CrossRefPubMed
23.
Damgaard S, Wetterslev J, Lund JT, et al. One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial. Eur Heart J. 2009;30:1005–11.CrossRefPubMed
24.
Nasso G, Popoff G, Lamarra M, et al. Impact of arterial revascularization in patients undergoing coronary bypass. J Card Surg. 2012;27:427–33.CrossRefPubMed
25.
Nasso G, Coppola R, Bonifazi R, et al. Arterial revascularization in primary coronary artery bypass grafting: direct comparison of 4 strategies—results of the Stand-in-Y Mammary Study. J Thorac Cardiovasc Surg. 2009;137:1093–100.CrossRefPubMed
26.
Carpentier A, Guermonprez JL, Deloche A, Frechette C, DuBost C. The aorta-to-coronary radial artery bypass graft: a technique avoiding pathological changes in grafts. Ann Thorac Surg. 1973;16:111–21.CrossRefPubMed
27.
Acar C, Jebara VA, Portoghese M, Beyssen B, Pagny JY, Grare P, Chachques JC, Fabiani JN, Deloche A, Guermonprez JL. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg. 1992;54:652–9.CrossRefPubMed
28.
Navia D, Vrancic M, Piccinini F, Camporrotondo M, Thierer J, Gil C, Benzadon M. Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study. J Thorac Cardiovasc Surg. 2014;147:632–8.CrossRefPubMed
29.
Ruttmann E, Fischler N, Sakic A, et al. Second internal thoracic artery versus radial artery in coronary artery bypass grafting: a long-term, propensity score-matched follow-up study. Circulation. 2011;124:1321–9.CrossRefPubMed
30.
Borger MA, Cohen G, Buth KJ, Rao V, Bozinovski J, Liaghati-Nasseri N, Mallidi H, Feder-Elituv R, Sever J, Christakis GT, Bhatnagar G, Goldman BS, Cohen EA, Fremes SE. Multiple arterial grafts. Radial versus right internal thoracic arteries. Circulation. 1998;98(Suppl):7–13.
31.
Khot UN, Friedman DT, Pettersson G, et al. Radial artery bypass grafts have an increased occurrence of angiographically severe stenosis and occlusion compared with left internal mammary arteries and saphenous vein grafts. Circulation. 2004;109:2086–91.CrossRefPubMed
32.
Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg. 2004;77:93–101.CrossRefPubMed
33.
Schwann TA, Hashim SW, Badour S, Obeid M, Engoren M, Tranbaugh RF, Bonnell MR, Habib RH. Equipoise between radial artery and right internal thoracic artery as the second arterial conduit in left internal thoracic artery-based coronary artery bypass graft surgery: a multi-institutional study. Eur J Cardiothorac Surg. 2016;49:188–95.CrossRefPubMed
34.
Yie K, Na CY, Oh SS, et al. Angiographic results of the radial artery graft patency according to the degree of native coronary stenosis. Eur J Cardiothorac Surg. 2008;33:341–8.CrossRefPubMed
35.
Dai C, Lu Z, Zhu H, Xue S, Lian F. Bilateral internal mammary artery grafting and risk of sternal wound infection: evidence from observational studies. Ann Thorac Surg. 2013;95:1938–45.CrossRefPubMed
36.
Cohen AJ, Lockman J, Lorberboym M, et al. Assessment of sternal vascularity with single photon emission computed tomography after harvesting of the internal thoracic artery. J Thorac Cardiovasc Surg. 1999;118:496–502.CrossRefPubMed
37.
de Jesus RA, Acland RD. Anatomic study of the collateral blood supply of the sternum. Ann Thorac Surg. 1995;59:163–8.CrossRefPubMed
38.
Lorberboym M, Medalion B, Bder O, et al. 99mTc-MDP bone SPECT for the evaluation of sternal ischaemia following internal mammary artery dissection. Nucl Med Commun. 2002;23:47–52.CrossRefPubMed
39.
Fukui T, Tabata M, Manabe S, et al. Graft selection and 1-year patency rates in patients undergoing coronary artery bypass grafting. Ann Thorac Surg. 2010;89:1901–5.CrossRefPubMed
40.
Sergeant P, Blackstone E, Meyns B, Stockman B, Jahari R. First cardiological or cardiosurgical reintervention for ischemic heart disease and after primary coronary artery bypass grafting. Eur J Cardiothorac Surg. 1998;14:480–7.CrossRefPubMed
41.
Head SJ, Mack MJ, Holmes DR Jr, et al. Incidence, predictors and outcomes of incomplete revascularization after percutaneous coronary intervention and coronary artery bypass grafting: a subgroup analysis of 3-year SYNTAX data. Eur J Cardiothorac Surg. 2012;41:535–41.CrossRefPubMed
42.
Benedetto U, Angeloni E, Refice S, et al. Radial artery versus saphenous vein graft patency: meta-analysis of randomized controlled trials. J Thorac Cardiovasc Surg. 2010;139:229–31.CrossRefPubMed
43.
Athanasiou T, Saso S, Rao C, et al. Radial artery versus saphenous vein conduits for coronary artery bypass surgery: 40 years of competition—which conduit offers better patency? A systematic review and meta-analysis. Eur J Cardiothorac Surg. 2011;40:208–20.CrossRefPubMed
44.
Hayward PA, Gordon IR, Hare DL, et al. Comparable patencies of the radial artery and right internal thoracic artery or saphenous vein beyond 5 years: results from the Radial Artery Patency and Clinical Outcomes trial. J Thorac Cardiovasc Surg. 2010;139:60–5 (discussion 65–7).CrossRefPubMed
45.
Mohammadi S, Dagenais F, Voisine P, Dumont E, Charbonneau E, Marzouk M, Paramythiotis A, Kalavrouziotis D. Impact of the radial artery as an additional arterial conduit during in-situ bilateral internal mammary artery grafting: a propensity score-matched study. Ann Thorac Surg. 2016;101:913–8.CrossRefPubMed
46.
Tranbaugh RF, Dimitrova KR, Friedmann P, Geller CM, Harris LJ, Stelzer P, Cohen BM, Ko W, DeCastro H, Lucido D, Hoffman DM. Coronary artery bypass grafting using the radial artery: clinical outcomes, patency, and need for reintervention. Circulation. 2012;126(Suppl):S170–5.CrossRefPubMed
47.
Cao C, Manganas C, Horton M, Bannon P, Munkholm-Larsen S, Ang SC, Yan TD. Angiographic outcomes of radial artery versus saphenous vein in coronary artery bypass graft surgery: a meta-analysis of randomized controlled trials. J Thorac Cardiovasc Surg. 2013;146:255–61.CrossRefPubMed
48.
49.
50.
Suma H, Tanabe H, Takahashi A, Horii T, Isomura T, Hirose H, Amano A. Twenty years experience with the gastro-epiploic artery for CABG. Circulation. 2007;116(Suppl 1):188–91.
51.
Puig LB, Sousa AH, Cividanes GV, et al. Eight years experience using the inferior epigastric artery for myocardial revascularization. Eur J Cardiothorac Surg. 1997;11:243–7.CrossRefPubMed
52.
Edwards WS, Lewis CE, Blakeley WR, Napolitano L. Coronary artery bypass with internal mammary and splenic artery grafts. Ann Thorac Surg. 1973;15:35–40.CrossRefPubMed
53.
Buxton BF, Chan AT, Dixit AS, et al. Ulnar artery as a coronary bypass graft. Ann Thorac Surg. 1998;65:1020–4.CrossRefPubMed
54.
van Son JA, Smedts F, Korving J, et al. Intercostal artery: histomorphometric study to assess its suitability as a coronary bypass graft. Ann Thorac Surg. 1993;56:1078–81.CrossRefPubMed
55.
Laub GW, Muralidharan S, Clancy R, et al. Cryopreserved allograft veins as alternative coronary artery bypass conduits: early phase results. Ann Thorac Surg. 1992;54:826–31.CrossRefPubMed
56.
Mitchell IM, Essop AR, Scott PJ, et al. Bovine internal mammary artery as a conduit for coronary revascularization: long-term results. Ann Thorac Surg. 1993;55:120–2.CrossRefPubMed
57.
Sapsford RN, Oakley GD, Talbot S. Early and late patency of expanded polytetrafluoroethylene vascular grafts in aorta-coronary bypass. J Thorac Cardiovasc Surg. 1981;81:860–4.PubMed
58.
Englberger L, Noti J, Immer FF, Stalder M, Eckstein FS, Carrel TP. The Shelhigh No-React bovine internal mammary artery: a questionable alternative conduit in coronary bypass surgery? Eur J Cardiothorac Surg. 2008;33:222–4.CrossRefPubMed
59.
Seifu DG, Purnama A, Mequanint K, Mantovani D. Small-diameter vascular tissue engineering. Nat Rev Cardiol. 2013;10:410–21.CrossRefPubMed
60.
Arif R, Farag M, Gertner V, Szabó G, Weymann A, Veres G, Ruhparwar A, Bekeredjian R, Bruckner T, Karck M, Kallenbach K, Beller CJ. Female gender and differences in outcome after isolated coronary artery bypass graft surgery: does age play a role? PLoS One. 2016;4(11):e0145371.CrossRef
61.
Buxton BF, Hayward PA. The art of arterial revascularization-total arterial revascularization in patients with triple vessel coronary artery disease. Ann Cardiothorac Surg. 2013;2:543–51.PubMedPubMedCentral
62.
Galbut DL, Kurlansky PA, Traad EA, et al. Bilateral internal thoracic artery grafting improves long-term survival in patients with reduced ejection fraction: a propensity-matched study with 30-year follow-up. J Thorac Cardiovasc Surg. 2012;143(844–853):e4.
63.
Tatoulis J, Buxton BF, Fuller JA. The right internal thoracic artery: forgotten conduit, 5766 patients and 991 angiograms. Ann Thorac Surg. 2011;92:9–17.CrossRefPubMed
64.
Serruys PW, Unger F, Sousa JE, Jatene A, Bonnier HJ, Schönberger JP, Buller N, Bonser R, van den Brand MJ, van Herwerden LA, Morel MA, van Hout BA, Arterial Revascularization Therapies Study Group. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease. N Engl J Med. 2001;344:1117–24.CrossRefPubMed
65.
Aldea GS, Bakaeen FG, Pal J. The Society of Thoracic Surgeons Clinical Practice Guidelines on arterial conduits for coronary artery bypass grafting. Ann Thorac Surg. 2016;101:801–9.CrossRefPubMed
66.
Puskas JD, Yanagawa B, Taggart DP. Advancing the state of the art in surgical coronary revascularization. Ann Thorac Surg. 2016;101:419–21.CrossRefPubMed
67.
Tranbaugh RF, Lucido DJ, Dimitrova KR, Hoffman DM, Geller CM, Dincheva GR, Puskas JD. Multiple arterial bypass grafting should be routine. J Thorac Cardiovasc Surg. 2015;150(1537–44):1544–5.
68.
Shi WY, Tatoulis J, Newcomb AE, Rosalion A, Fuller JA, Buxton BF. Is a third arterial conduit necessary? Comparison of the radial artery and saphenous vein in patients receiving bilateral internal thoracic arteries for triple vessel coronary disease. Eur J Cardiothorac Surg. 2016;50(1):53–60.
Metadaten
Titel
Current trends in selection of conduits for coronary artery bypass grafting
verfasst von
Thierry Carrel
Bernhard Winkler
Publikationsdatum
09.08.2017
Verlag
Springer Japan
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 10/2017
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-017-0807-8

Weitere Artikel der Ausgabe 10/2017

General Thoracic and Cardiovascular Surgery 10/2017 Zur Ausgabe

Original Article

Risk assessment and outcomes of vasoplegia after cardiac surgery

Original Article

Efficacy of CO2 insufflation during thoracoscopic esophagectomy in the left lateral position

Original Article

Surgical outcome of wide wedge resection in poor-risk patients with clinical-N0 non-small cell lung cancer

Original Article

Collaborative operation with cardiovascular surgeons in general thoracic surgery

How to Do It

New minimally invasive surgical approach for excision of left atrial myxoma

Case Report

Total thoracoscopic left ventricular lead implantation for hybrid cardiac resynchronization therapy in pacemaker-mediated cardiomyopathy

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.