Chinese Medical Sciences Journal ›› 2018, Vol. 33 ›› Issue (2): 69-76.doi: 10.24920/11811
• Original Article • Next Articles
Midterm Follow-up of Coronary Artery Bypass Grafting with 64-Slice Multi-detector Computed Tomography: Identification of Risk Factors Affecting Graft Patency
Li Tao, Yang Li(
), Zhang Weiguo, Luo Chuncai, Huang Zili, Li Jinfeng, Li Xin
- Radiology Department, PLA General Hospital, Beijing 100853, China
-
Received:2017-06-12Published:2018-06-30Online:2018-05-29 -
Contact:Yang Li E-mail:yangli301@yeah.net
Cite this article
Li Tao, Yang Li, Zhang Weiguo, Luo Chuncai, Huang Zili, Li Jinfeng, Li Xin. Midterm Follow-up of Coronary Artery Bypass Grafting with 64-Slice Multi-detector Computed Tomography: Identification of Risk Factors Affecting Graft Patency[J].Chinese Medical Sciences Journal, 2018, 33(2): 69-76.
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| Clinical characteristics | Patient groups | In total | t or χ2value | Pvalue | |
|---|---|---|---|---|---|
| Patent grafts (n=231) | Poor patent grafts (n=110) | ||||
| Sex | |||||
| Male, n (%) | 188(81.4) | 85(77.3) | 273 | 0.79 | 0.37 |
| Female, n (%) | 43(18.6) | 25(22.7) | 68 | ||
| Age, years | 62.7±10.3 | 62.5±10.0 | 62.6±10.2 | 0.42 | 0.87 |
| Bypass grafts, n (%) | 574 | 320 | 894 | ||
| Body Mass Index | 30.1±5.8 | 30.5±6.1 | 30.2±5.9 | 0.55 | 0.45 |
| History of | |||||
| Diabetes, n (%) | 72(31.2) | 41(37.3) | 113 | 1.25 | 0.26 |
| Hypertension, n (%) | 157(68.0) | 61(55.5) | 218 | 5.06 | 0.025 |
| Dyslipidemia, n (%) | 58(25.1) | 38(34.5) | 96 | 3.28 | 0.07 |
| Smoking, n (%) | 118(51.1) | 48(43.6) | 166 | 1.65 | 0.20 |
| Cerebrovascular disease, n (%) | 28 (12.1) | 26 (23.6) | 54 | 7.41 | 0.006 |
| Post-operative adjuvant medication | |||||
| Beta blocker, n (%) | 101(43.7) | 48(43.6) | 149 | 0.00 | 0.98 |
| ACE inhibitor, n (%) | 58(25.1) | 27(24.5) | 85 | 0.01 | 0.9 |
| Statin, n (%) | 107(46.3) | 49(44.5) | 156 | 0.10 | 0.76 |
| Calcium channel blocker, n (%) | 21(9.1) | 9(8.2) | 30 | 0.08 | 0.78 |
| Symptomatic, n (%) | 39(16.9) | 15(13.6) | 54 | 0.59 | 0.44 |
Figure 1.
Volume rendering (VR) and Multi-planar reconstruction (MPR) images of a 72-year-old male who had coronary artery bypass graft (CABG) operation one year ago show the grafts were all patent. A and D, the left internal mammary artery graft (long arrow) was anastomosed to the left anterior descending artery(short arrow); B and E, the saphenous veins graft (long arrow) was anastomosed to the obtuse marginal branch (short arrow); C and F, another saphenous vein graft (long arrow) was anastomosed to the left ventricular posterior branch (short arrow)."
Figure 1.
Figure 2.
MPR image and VR image of a 54-year-old male who had coronary artery bypass graft operation 15 months ago. VR image (A) and MPR image (B) show the two saphenous vein grafts (white arrows) were all occluded. SVG: saphenous vein graft; AO: aorta."
Figure 2.
"
| Graft type | Target vessel | Patent, n (%) (n=751) | Poor patent, n (%) (n=143) | In total (n=894) |
|---|---|---|---|---|
| LIMA* | 294(89.1) | 36(10.9) | 330 | |
| LAD | 292(89.6) | 34(10.4) | 326 | |
| RCA | 2(50.0) | 2(50.0) | 4 | |
| SV** | 457(81.0) | 107(19.0) | 564 | |
| D | 69(69.0) | 31(31.0) | 100 | |
| OM | 193(85.4) | 33(14.6) | 226 | |
| RCA territory | 195(81.9) | 43(18.1) | 238 | |
"
| Variates | Patency of LIMA grafts | Patency of SV grafts | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Patent n=294 | Poor patent, n=36 | χ2 | P value | Patent n=457 | Poor patent n=107 | χ2 | Pvalue | ||
| Male, n (%) | 266(90.5) | 29(80.6) | 6.85 | 0.03 | 372(81.4) | 82(76.6) | 1.22 | 0.27 | |
| Hypertension, n(%) | 259(88.1) | 33(91.7) | 0.68 | 0.71 | 383(83.8) | 79(73.8) | 8.06 | 0.005 | |
| Dyslipidemia, n(%) | 259(88.1) | 32(88.9) | 2.53 | 0.28 | 340(74.4) | 91(85.0) | 3.56 | 0.04 | |
| Diabetes, n (%) | 267(90.8) | 32(88.9) | 1.08 | 0.58 | 345(75.5) | 89(83.2) | 4.39 | 0.036 | |
| Smoking, n (%) | 268(91.2) | 31(86.1) | 2.76 | 0.25 | 376(82.3) | 84(78.5) | 1.36 | 0.24 | |
| Cerebrovascular disease, n (%) | 230(78.2) | 33(91.7) | 10.47 | 0.005 | 366(80.1) | 86(80.4) | 0.00 | 0.98 | |
| Symptomatic, n(%) | 255(86.7) | 32(88.9) | 0.57 | 0.75 | 326(71.3) | 88(82.2) | 5.18 | 0.023 | |
| Proximal target vessel stenosis >90%, n (%) | 290(98.6) | 14(38.9) | 169 | <0.001 | NA | NA | NA | NA | |
"
| Risk factors | LIMA graft closure (n=330) | SV graft closure (n=564) | |||
|---|---|---|---|---|---|
| Odds ratio (95% CI) | Pvalue | Odds ratio (95% CI) | Pvalue | ||
| Gender | 3.82(0.73-20.05) | 0.11 | 1.38 (0.77-2.50) | 0.28 | |
| Hypertension | 1.99(0.39-10.05) | 0.41 | 0.61(0.38-0.98) | 0.04 | |
| Dyslipidemia | 1.48 (0.30-7.37) | 0.64 | 1.52(1.00-2.5) | 0.048 | |
| Diabetes | 0.14(0.02-1.32) | 0.09 | 1.28(0.90-2.26) | 0.045 | |
| Smoking | 0.53(0.10-2.93) | 0.47 | 0.96(0.59-1.57) | 0.88 | |
| Cerebrovascular disease | 2.55(0.41-15.93) | 0.32 | 1.0(0.53-1.88) | 1.00 | |
| Symptomatic | 1.01(0.09-11.25) | 0.99 | 1.81(1.33-4.15) | 0.003 | |
| Proximal target vessel stenosis <90% | 0.015(0.01-0.14) | 0.000 | NA | NA | |
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