Computerized tomographic angiography in patients having eSVS Mesh ^® supported coronary saphenous vein grafts: intermediate term results

Abstract

Background

The Saphenous Vein (SVG) is used in over 80% of coronary artery bypass procedures (CABG) and SVG patency is the Achilles heel of CABG. To address this issue, the eSVS Mesh®, an external Nitinol knitted mesh, fitted like a sleeve over the vein graft preventing over expansion in the high pressure arterial system, has been introduced to improve disease management. Patency data is limited. The objective of this retrospective study is to report patency rates (>3 months) in patients having external mesh support as part of CABG.

Methods

From October 25, 2010 through February 13, 2012, 21 patients had external mesh support of SVG grafts in addition to internal thoracic artery grafting to the Anterior Descending artery. Patients were invited to return for patency evaluation using Computerized Tomographic angiography (CTA) an average of 7.2 months post-operative (R = 3-14 months).

Results

21 male patients (age 57 +/- 9 years) underwent on-pump surgery. The eSVS Mesh was successfully placed on all SVGs. All grafts were determined patent intra-operative by transit time Doppler measurement and there were no operative revisions. There was no operative mortality. 12 of the 21 contacted patients returned for CTA, 8 non-returning patients contacted were alive and asymptomatic but refused to return due to travel restrictions or cost. One patient was lost to follow up. 11 returning patients underwent CTA. One patient was excluded (asymptomatic) due to elevated creatinine. Of the 23 anastomoses in 11 patients (Average: 2.09 grafts/patient) using SVG available for examination, 21 were patent (92%).

Conclusions

In this retrospective non-randomized experience, the external mesh supported grafts displayed excellent intermediate patency.