How serious is a proximal occlusion of a posterolateral sequential bypass

摘要: The sequential coronary bypass, despite having several demonstrated benefits, has been criticized for being solely dependent upon 1 proximal anastomosis. aim of this study was to evaluate the danger a occlusion posterolateral bypass graft. Between January 1984 and 31 December 1994, 3,203 patients underwent primary artery grafting with at least vein graft (780 received 2,423 2). There were 5,626 grafts: 3,492 (62%) 2,134 antero-latero-septal (38%) grafts. 73 hospital deaths (2.3%). Follow-up performed on 3,130 survivors (5,504 grafts), an average 59 +/- 36 months (range, 11 years). During follow-up, total 250 symptomatic occlusions occurred in (8.0%). Only 23 (0.7%) surviving 3,431 grafts had occlusion, 35.9 5.9 postoperatively, all distal anastomoses remaining patent. Twenty-two so affected presented angina myocardial infarction. no mortality. In 12 (52%), medical treatment sufficient, while (48%) successful repeat revascularization. operation consisted simple from aorta distally patent patients. Four additional due progression disease. 10-year survival rate 86.7%. Symptomatic only segment occurs rarely low risk infarction mortality, provided that terminal anastomosis is high-flow vessel.