Revascularization of the Right Coronary Artery
HILLEL LAKS, MD, FACC GEORGE C. KAISER, MD, FACC J. GERARD MUDD, MD, FACC JOHN HALSTEAD GLENN PENNINGTON, MD DENNIS TYRAS, MD JOHN CODD, MD HENDRICK
B. BARNER,
MD,
FACC
St. Louis, Missouri
From the Department of Surgery, St. Louis University School of Medicine, St. Louis, Missouri. Manuscript received September 27, 1978; revised manuscript received January 9, 1979, accepted January 10. 1979. Address for reprints: Hillel Laks, MD, Department of Cardiothoracic Surgery, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.
This study was undertaken to evaiuiate revascuiarization of the right coronary artery with regard to factors that enter into the decision to graft less significant lesions, such as graft fiow, graft patency and progression of proximal disease. The resuits of grafting the right coronary artery were studied in 23 patients with lesions reducing iumfnai diameter by iess than 50 percent (Group I), 35 patients with iuminai narrowing of 50 to 70 percent (Group 2) and 112 patients with greater than 70 percent iuminai narrowing (Group 3). At operation there was no significant difference in saphenous vein graft flows among the three groups. Postoperatively the mean foiiow-up pertod was 20, 27 and 26 months, respectively. Graft patency was not significantly different among the three groups. Progression ‘of the proximal lesion was studied and compared with that in 71 ungrafted right coronary arteries, 60 with less than 50 percent stenosis and 11 with more than 50 percent stenosis. Among vesseis with less than 50 percent narrowing, the proximal lesion showed progression in 23 percent of the ungrafted vessels and in 83 percent of the grafted vessels (P
HILLEL LAKS, MD, FACC GEORGE C. KAISER, MD, FACC J. GERARD MUDD, MD, FACC JOHN HALSTEAD GLENN PENNINGTON, MD DENNIS TYRAS, MD JOHN CODD, MD HENDRICK
B. BARNER,
MD,
FACC
St. Louis, Missouri
From the Department of Surgery, St. Louis University School of Medicine, St. Louis, Missouri. Manuscript received September 27, 1978; revised manuscript received January 9, 1979, accepted January 10. 1979. Address for reprints: Hillel Laks, MD, Department of Cardiothoracic Surgery, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.
This study was undertaken to evaiuiate revascuiarization of the right coronary artery with regard to factors that enter into the decision to graft less significant lesions, such as graft fiow, graft patency and progression of proximal disease. The resuits of grafting the right coronary artery were studied in 23 patients with lesions reducing iumfnai diameter by iess than 50 percent (Group I), 35 patients with iuminai narrowing of 50 to 70 percent (Group 2) and 112 patients with greater than 70 percent iuminai narrowing (Group 3). At operation there was no significant difference in saphenous vein graft flows among the three groups. Postoperatively the mean foiiow-up pertod was 20, 27 and 26 months, respectively. Graft patency was not significantly different among the three groups. Progression ‘of the proximal lesion was studied and compared with that in 71 ungrafted right coronary arteries, 60 with less than 50 percent stenosis and 11 with more than 50 percent stenosis. Among vesseis with less than 50 percent narrowing, the proximal lesion showed progression in 23 percent of the ungrafted vessels and in 83 percent of the grafted vessels (P
