Saphenous Vein Graft Patency When Anastomosed to Distal Right Coronary Artery versus Right Posterior Descending Artery: A Comparative Study

Background: The failure of the saphenous vein graft (SVG) is a critical flaw in coronary artery bypass grafting (CABG) that has been associated with bad cardiac outcomes such as the necessity to repeat coronary revascularization, recurrent angina, myocardial infarction, and mortality. Objective: To compare mid-term patency of saphenous vein graft used for revascularization of the RCA when anastomosed to Distal Right Coronary Artery (DRCA) versus Right Posterior Descending Artery (RPDA) in proximal RCA lesion in patients who underwent isolated CABG.
Patients and method: 80 patients who underwent isolated CABG with saphenous vein graft utilized for revascularization of RCA with proximal lesions were enrolled. Patients had been randomly allocated into 2 groups depending on the site of RCA anastomosis. In Group A (n=40), SVG was anastomosed to DRCA, while in Group B (n=40) SVG was anastomosed to RPDA. The postoperative multislice coronary angiography (MSCT) was used for evaluation of patency of the SVGs, and the presence of graft occlusion through mid-term follow ups. Results: 30 of the 80 SVGs used for RCA revascularization were found to be occluded, whereas the remaining 50 were determined to be patent. Group A had a significantly greater mean age than Group B (p < 0.05); nevertheless, no statistically significant difference between the study groups was detected in terms of cardiovascular disease risk factors (p>0.05). Group A had similar patency rates (50% patent and 50% occluded), while group B had much greater patency rates (75% patent and 25% occluded, p =0.001). Moreover, the target vessel's mean diameter was substantially greater in group A (p-value=0.001).
Conclusion: The findings corroborate the hypothesis that SVG anastomosed to RPDA are more patent than those anastomosed to DRCA.