Coronary Artery Bypass Grafting Using Side-to-Side Anastomosis with Distal End Clipping of the Saphenous Vein Graft
Katsuhiko Matsuyama*, Masahiko Kuinose, Nobusato Koizumi, Tomoaki Iwasaki, Kayo Toguchi and Hitoshi Ogino
Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku Tokyo 160-0023, Japan
- *Corresponding Author:
- Katsuhiko Matsuyama
Department of Cardiovascular Surgery
Tokyo Medical University Hospital
6-7-1 Nishshinjuku Shinjyuku-ku
Tokyo 160-0023, Japan
E-mail: [email protected]
Received Date: May 13, 2014; Accepted Date: July 23, 2014; Published Date: July 26, 2014
Citation: Matsuyama K, Kuinose M, Koizumi N, Iwasaki T, Toguchi K, et al. (2014) Coronary Artery Bypass Grafting Using Side-To-Side Anastomosis with Distal End Clipping of the Saphenous Vein Graft . J Vasc Med Surg 2:145. doi: 10.4172/2329-6925.1000145
Copyright: © 2014 Matsuyama K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Although the Saphenous Vein Graft (SVG) is commonly grafted to the coronary artery with an end-to-side anastomotic technique, there is often a significant mismatch between the diameters of the SVG and the coronary artery, which may cause SVG failure. To overcome such a drawback of the standard end-to-side SVG anastomosis, we introduce a novel side-to-side anastomosis with distal end clipping of the SVG in coronary artery bypass grafting. The long-term outcome of Coronary Artery Bypass Grafting (CABG) depends predominantly on graft patency. Although an arterial graft is preferably used to improve long-term graft patency, a Saphenous Vein Graft (SVG) is also still widely used as a second bypass graft.
The reported SVG patency ranging from 25% to >50% within 10 years was inferior to that of an arterial graft, despite considerable efforts to prevent SVG failure. Although the SVG is commonly grafted to the coronary artery with an end-to-side anastomotic technique, there is often a significant mismatch between the diameters of the SVG and the coronary artery, which may cause SVG failure. Moreover, the end-to-side anastomotic configuration has been reported to have an adverse effect on local hemodynamics, resulting in intimal hyperplasia in the long-term. The intimal hyperplasia, which is a major cause of late graft failure, has been shown to occur predominantly at the toe, heel, and bed of the host coronary artery around the distal anastomosis