The Journal of Thoracic and Cardiovascular Surgery, Vol 73, 660-667, Copyright © 1977 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Mechanisms of occlusion of saphenous vein--coronary artery "jump" grafts
GM Hutchins and BH Bulkley
Seven patients with 12 end-to-side and eight side-to-side saphenous vein
graft-to-coronary artery anastomoses were studied at autopsy. Postmortem
coronary arteriograms and serial histologic sections of the anastomoses
were performed. Occlusive changes occurring in the coronary arteries tended
to be at the ends of the arteriotomy and could be attributed to reduction
of arterial circumference from its eversion and utilization in the
anastomotic connection, or from thrombosis along the suture line or from
both. The mechanisms of arterial occlusion were the same in side-to-side
and end-to-side anastomoses. In addition to the occlusive changes at the
anastomosis, "jump" grafts with two anastomoses were susceptible to rolling
or kinking of the graft, apparently as a result of torsion from placement
of the side-to-side anastomosis.
