Predictors of early graft patency following coronary artery bypass surgery.

Background: The long-term success of coronary artery bypass graft surgery (CABG) is dependent on graft patency after the operation. Early occlusion (within the first week) affects the long-term results. Therefore, we sought to determine pre-operative, intraoperative, and perioperative factors associated with early coronary graft patency.

Methods: Between March 2007 and March 2008, 107 consecutive patients (81 men, 26 women, mean age 60 +/- 9 years) who underwent CABG were included in this study. The enrolled patients underwent 16-slice computed tomography angiography one week after CABG.

Results: Based on the multislice computed tomography, acute graft occlusion was detected in 32 (8.7% of all) grafts, including 26 of 250 (10%) in venous grafts and 6 of 116 (5%) in arterial grafts. In univariate analysis, patients with patent coronary grafts had a lower serum glucose level (119 +/- 30 vs. 141 +/- 65 mg/dL, p = 0.02) and longer partial thromboplastin time (34 +/- 11 vs. 30 +/- 2 s, p = = 0.04). In addition, pump time was significantly longer in patients with occluded grafts than in those with patent grafts (119 +/- 43 vs. 102 +/- 32 min, p = 0.04). Those with longer pump time required more coronary grafts (pump time > or = 120 min for 3.5 grafts vs. pump time < 120 min for 2.9 grafts, p = 0.02). Of the multiple pre-operative, intraoperative, and perioperative characteristics of the patients who underwent successful CABG, serum glucose level (OR: 2.014, 95% CI: 1.002-3.026, p = 0.002) and pump time < two hours (OR: 1.502, 95% CI: 1.001-2.030, p = 0.003) were the only predictors of coronary graft patency seven days after surgery in multivariate analysis.

Conclusions: Our study demonstrated that the patients with successful CABG and patent coronary grafts within the first week after surgery had optimal blood glucose control and pump time < two hours.