Comparison of Saph Vein Graft versus Right GE Artery to Revasc. the Right Coron. Artery: Prospective Randomized Clinical, Function. & Angiogr. Mid-term Eval.

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David Glineur, Claude Hanet, Alain Poncelet, William D’hoore, Jean-Christophe Funken, Jean Rubay, Joelle Kefer, Olivier Gurner, Jean Renkin, Nadia Debbas, Parla Astarci, Valerie Lacroix, Robert Verhelst, Pierre Yves Etienne, Philippe Noirhomme, Gebrine El Khoury

 

Cliniques Universitaires Saint-Luc, Bruxelles

Objectives: RGEA graft has not been worldwide accepted as the ideal graft to revascularize the RCA therefore we prospectively randomized two types of graft and have evaluated the clinical, functional and angiographic evolution at 6 months and 3 years

Methods: From 03/2003 to 10/2006, 1397 consecutive patients underwent isolated CABG in our institution. Of these, 370 met the inclusion criteria for randomization and 66% were randomized. RCA was revascularized in 116 patients with SVG and with the RGEA in 122 patients. All patients underwent angiographic control at 6 months and stress test twice a year after surgery. End point were: MACE and proportion of grafts patent or functional at follow-up angiography

Results: There were no significant differences between the 2 groups in terms of hospital events. Clinical follow-up is 100 % complete with a mean of 18 months. At follow-up there was no significant difference in MACE between the 2 groups. Six months angiographic follow-up is 85% complete. 91% of the anastomosis in the RGEA group and 95% in the SVG group were controled patent (p=0.92). In none occluded RCA, the proportion of patent graft or not functioning grafts were more frequent in the RGEA group than in the SVG group.

Conclusions: Good early patency rate was achieved in both groups with no significant difference in terms of MACE or patency but the number of functional graft was significantly higher in the SVG group. Careful selection of the coronary target is mandatory to obtain good results in case of gastroepiploic artery grafting.