The Annals of Thoracic Surgery, Vol 30, 550-557, Copyright © 1980 by The Society of Thoracic Surgeons
Aortocoronary bypass with homologous saphenous vein: long-term results
O Bical, J Bachet, C Laurian, JP Camilleri, B Goudot, P Menu and D Guilmet
Between February 1973, and February, 1979, 27 homologous saphenous veins
were used in 20 patients (mean age, 54 years). Seven fresh grafts were used
less than 24 hours after severance. They were kept at a temperature of 4
degrees C in saline solution containing penicillin. Twenty cryopreserved
grafts were used within a period of eight days to 2 months from severance.
They were preserved in glycerol at a temperature of -40 degrees C. One
patient (5%) died postoperatively. A perioperative myocardial infarction
developed in 3 patients (15%). Average follow-up is 27 months. No late
mortality was registered. Fifteen patients are free from symptoms, and 3
patients have residual angina with exercise. Control angiograms were made
in 13 patients 1 to 68 months after operation; 17 homografts were seen.
Early occlusion of 1 graft and late occlusion of 8 grafts were registered.
The poor late patency rate does not seem to be related to either
histocompatibility or technical conditions. Conversely, microscopic
examination of several cryopreserved grafts showed that the mode of
preservation resulted in deterioration of intimal and medial tissues of the
vein. Therefore, it appears to us that the use of homologous saphenous
veins should be avoided for coronary bypass.
