DOI: 10.25881/20728255_2024_19_3_112

Authors

Shengelia L.D., Konshina M.O., Sanakoev M.K., Fatulaev Z.F., Donakanyan S.A., Merzlyakov V.Yu.

A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow

Abstract

Coronary artery bypass grafting remains a widespread and vital treatment for patients with multivessel coronary artery disease, especially diabetics. Despite the success of the surgery, the long-term outcome of coronary bypass grafting is influenced by the choice of used grafts. Currently, the internal thoracic artery, radial artery, and saphenous vein graft are used as grafts in coronary bypass grafting. The long-term benefit of the anastomosis between the left internal thoracic artery and the anterior interventricular branch of the left coronary artery is well established and remains the gold standard for revascularization of severe coronary artery disease. The radial artery and saphenous vein are grafts of the second order. Presently, there are discussions about which of the grafts is more effective and more durable, since the long-term functioning of the grafts makes it possible to protect patients from the risk of recurrent symptoms of coronary heart disease and the development of life-threatening complications. Each conduit has its own pathophysiological, anatomical and histological features, in our opinion, the combination of the radial and internal thoracic arteries under the term «autoarterial bypass surgery» and the analysis of these conduits in a single group can lead to incorrect interpretation of the data and the formation of unreliable conclusions.

Keywords: coronary artery bypass grafting, radial artery, saphenous vein, left internal thoracic artery, bimammary bypass grafting.

References

1. Taggart D. Best practices in coronary revascularization procedures: are we where we should be? Curr Opin Cardiol. 2014; 29(6): 528-33. doi: 10.1097/HCO.0000000000000111.

2. Golukhova EZ, Keren MA, Zavalikhina TV, Bulaeva NI, et al. Prognosis of Early Outcomes after Isolated Coronary Bypass Surgery: Results of a Single-Center Cohort Study. Annals of the Russian Academy of Medical Sciences. 2023; 78(3): 176-184. (In Russ.)

3. Mamedova SK, Merzlyakov VYu, Kluchnikov IV, Tetvadze IV. Long-tern results of coronary artery bypass grafting on a beating heart and with cardiopulmonary bypass in patients with choronic coronary artery disease. Russian journal of Thoracic and Cardiovascular surgery. 2022; 64(6): 596-604. (In Russ.)

4. Jalilov A, Merzlyakov V, Klyuchnikov I, Salomov M, Mamedova S. Results of coronary bypass shutting in patienswith acute ST-elevation myocardial infarction. Modern science: actual problems of theory and practice. Series: Natural and Technical Sciences. 2022; 4(2): 203-207. (In Russ.)

5. Taggart D. Contemporary coronary artery bypass grafting Front. Med. 2014; 8(4): 395-398. doi: 10.1007/s11684-014-0374-7.

6. Kiesera T, Headb S, Kappetein A. Arterial grafting and complete revascularization: challenge or compromise? Curr Opin Cardiol. 2013; 28: 646-653. doi:10.1097/HCO.0000000000000001.

7. Garnizone M, Vartina E, Pilmane M. Morphologic comparison of blood vessels used for coronary artery bypass graft surgery ffiliations expand. 2022; 81(3): 584-593. doi: 10.5603/FM.a2021.0084.

8. Zacharias A, Habib R, Schwann T, Riordan C, Durham S, Shah A. Improved survival with radial artery versus vein conduits in coronary bypass surgery with left internal thoracic artery to left anterior descending artery grafting. Circulation. 2004; 109: 1489-96.

9. Eifert S, Mair H, Boulesteix A, et al. Mid-term outcomes of patients with PCI prior to CABG in comparison to patients with primary CABG. Vasc Health Risk Manag. 2010; 6: 495-501.

10. Krivenkova EM, Merzlyakov VYu, Skopin AI, Mamedova SK. The current state of the problem of bypass surgery of the left anterior descending artery using the left internal thoracic artery. Russian journal of Thoracic and Cardiovascular surgery. 2023; 65(1): 16-23. (In Russ.)

11. Smith M, Long D, Damiano E, et al. Near-Wall μ-PIV reveals a hydrodynamically relevant endothelial surface layer in venules in vivo. Biophysical J. 2003; 85(1): 637-645. doi: 10.1016/s0006-3495(03)74507-x.

12. Davierwala P, Mohr F. Internal mammary artery grafting: rationale and evidence. Int J Surg. 2015; 16: 133-9. doi: 10.1016/j.

13. Otsuka F, Yahagi K, Sakakura K, Virmani R. Why is the mammary artery so special and what protects it from atherosclerosis? Ann Cardiothorac Surg. 2013; 2(4): 519-526. doi: 10.3978/j.issn.

14. Kraler S, Libby P, Evans P, Akhmedov A, et al. The Internal Mammary Artery and its Resilience to Atherogenesis: Shifting from Risk to Resistance to Address Unmet Needs. Thromb Vasc Biol. 2021; 41(8): 2237-2251. doi: 10.1161/atvbaha. 121.316256.

15. Lu H, Sun L, Chen W, Zhou Y, Liu K, Chen J, et al. 3 therapy attenuates aging expression, oxidative stress parameters and neointimal hyperplasia formation in vein grafts. Annals of Vascular Surgery. 2019. doi: https://doi.org/10.1016/j.avsg.

16. Vermaa S, Lovrena F, Pana Y, Yanagawaa B, et al. Pedicled no-touch saphenous vein graft harvest limits vascular smooth muscle cell activation: the PATENT saphenous vein graft study. European Journal of Cardio-Thoracic Surgery. 2014; 45: 717-725. doi: 10.1093/ejcts/ezt560.

17. Collins M, Li X, Lv I, Protack Y, Muto A, Jadlowiec C, et al. Therapeutic strategies to combat neointimal hyperplasia in vascular grafts. Expert Rev Cardiovasc Ther. 2012; 10(5): 635-647. doi:10.1586/erc.12.33.

18. Muto A, Fitzgerald T, Pimiento J, et al. Smooth muscle cell signal transduction: implications of vascular biology for vascular surgeons. J Vasc Surg. 2007; 45(Suppl A): A15-A24.

19. Buziashvli YuI, Koksheneva IV, Petrosyan KV, et al. Influence of genetic markers of the endothelin system dysfunction on the prognosis after percutaneous coronary intervention. Bulletin of the A.N. Bakulev National Agricultural Academy of the Russian Academy of Sciences. Cardiovascular diseases. 2019; 20(9-10): 799-805. (In Russ.)

20. Wang X, Shao Y, Ma C, Chen W, et al. Decreased SIRT3 in aged human mesenchymal stromal/stem cells increases cellular susceptibility to oxidative stress. J Cell Mol Med. 2014; 18: 2298-310.

21. Gheibi S, Jeddi S, Kashfi K, Ghasemi A. Regulation of vascular tone homeostasis by NO and H2S: Implications in hypertension. Biochem Pharmacol. 2018; 149: 42-59.

22. Tanner F, Meier P, Greutert H, Champion C, Nabel E, Luscher T. Nitric oxide modulates expression of cell cycle regulatory proteins: a cytostatic strategy for inhibition of human vascular smooth muscle cell proliferation. Circulation. 2000; 101: 1982-9.

23. Kapadia M, Eng J, Jiang Q, Stoyanovsky D, Kibbe M. Nitric oxide regulates the 26S 471 proteasome in vascular smooth muscle cells. Nitric Oxide. 2009; 20: 279-88.

24. Ishmuhametov G, Zavarzina D, Ismail-zade IK, Grebennik V Selection of conduits in coronary artery surgery. Russian Journal of Thoracic and Cardiovascular Surgery. 2020; 62 (6): 513-9. (In Russ.) doi: 10.24022/0236-2791-2020-62-6-513-519.

25. Shevchenko YUL, Borshchev GG, Ulbashev DS, Zemlyanov AV. Choice of conduits in coronary surgery. Bulletin of Pirogov National Medical & Surgical Center. 2019; 14(1): 97-104. (In Russ.)

26. Golubev EP. Surgery of coronary heart disease. News of cardiovascular surgery. 2019; 3(2): 45-147. (In Russ.)

For citation

Shengelia L.D., Konshina M.O., Sanakoev M.K., Fatulaev Z.F., Donakanyan S.A., Merzlyakov V.Yu. Modern views and approaches to the choice of grafts during coronary artery bypass grafting: Basic concepts and terms in need of revision. Bulletin of Pirogov National Medical & Surgical Center. 2024;19(3):112-117. (In Russ.) https://doi.org/10.25881/20728255_2024_19_3_112