0
Articles |

Antithrombotic Therapy in Patients With Saphenous Vein and Internal Mammary Artery Bypass Grafts

Paul D. Stein, MD, FCCP, Chairman; James E. Dalen, MD, FCCP; Steven Goldman, MD; Pierre Theroux, MD
Author and Funding Information

Correspondence to: Paul D. Stein, MD, FCCP, St. Joseph Mercy-Oakland Hospital, 44555 Woodward Ave, Suite 107, Pontiac, MI 48341-2964.



Chest. 2001;119(1_suppl):278S-282S. doi:10.1378/chest.119.1_suppl.278S
Text Size: A A A
Published online

Extract

One of the major complications of coronary artery bypass grafts is graft closure, and this is largely related to platelet aggregation. Almost immediately after harvesting the saphenous vein, the endothelium is lost and the raw surface is vulnerable to platelet aggregation.1 This may explain the need for early antithrombotic treatment. Intraoperative factors affect graft patency,2 and these may partially relate to endothelial damage. Graft patency was reduced if operation time was > 5 h, bypass time was > 2 h,cross-clamp time was > 80 min, the temperature of the vein preservation solution was > 5°C, intermittent cross-clamping rather than continuous cross-clamping was used, or if there were more than two proximal anastomoses.2 Some types of fluid used for storage and rinsing of the vein grafts preserved endothelial function better than others and contributed to graft patency.3 Grafts ≥ 1.5 mm in diameter had a higher patency rate after 1 year than smaller grafts.34 Grafts inserted in regions of normal wall motion had higher patency rates than grafts with abnormal wall motion in the region of insertion.4 Aggressive lowering of low-density lipoprotein cholesterol levels resulted in a reduced number of occluded grafts.5

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543