Coronary artery bypass grafts
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Coronary artery bypass grafts are a treatment for atherosclerotic heart disease (ASHD). They are created in a procedure called coronary artery bypass surgery, also coronary artery bypass grafting, abbreviated CABG. CABGs are encountered by pathologists at autopsy.
The other treatments for ASHD are medical management, and percutaneous coronary intervention (PCI).
Indications
Indications for CABG:[1]
- Left main coronary artery disease.
- Triple vessel disease.
- Disease involving the left anterior descending (coronary artery), left circumflex coronary artery and right coronary artery.
Gross
Types of grafts
- Arterial - usually internal thoracic artery.
- Venous - saphenous vein.
Notes:
- Arterial grafts, generally, are much longer lived ~90% patency at 10 years verus ~57% for saphenous vein grafts.[2]
Identification
All grafts should be identified:
- Proximal anastomosis - if applicable.
- Distal anastomosis.
Common configurations:
- Arterial - left internal thoracic artery (LITA) - usu. to the distal LAD.
- Venous - RCA, LCx.
See also
References
- ↑ Serruys, PW.; Morice, MC.; Kappetein, AP.; Colombo, A.; Holmes, DR.; Mack, MJ.; Ståhle, E.; Feldman, TE. et al. (Mar 2009). "Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease.". N Engl J Med 360 (10): 961-72. doi:10.1056/NEJMoa0804626. PMID 19228612.
- ↑ Sabik, JF.; Lytle, BW.; Blackstone, EH.; Houghtaling, PL.; Cosgrove, DM. (Feb 2005). "Comparison of saphenous vein and internal thoracic artery graft patency by coronary system.". Ann Thorac Surg 79 (2): 544-51; discussion 544-51. doi:10.1016/j.athoracsur.2004.07.047. PMID 15680832.