Abstract
Objectives
To assess the effect of DuraGraft (Somahlution Inc, Jupiter, Fla), an intraoperative
graft treatment, on saphenous vein grafts in patients undergoing isolated coronary
artery bypass grafting.
Methods
Within patients, 2 saphenous vein grafts were randomized to DuraGraft or heparinized
saline. Multidetector computed tomography angiography at 1, 3, and 12 months assessed
change in wall thickness (primary end point at 3 months), lumen diameter, and maximum
narrowing for the whole graft and the proximal 5-cm segment. Safety end points included
graft occlusion, death, myocardial infarction, and repeat revascularization.
Results
At 3 months, no significant changes were observed between DuraGraft- and saline-treated
grafts (125 each) for wall thickness, lumen diameter, and maximum narrowing. At 12 months,
DuraGraft-treated grafts demonstrated smaller mean wall thickness, overall (0.12 ± 0.06
vs 0.20 ± 0.31 mm; P = .02) and in the proximal segment (0.11 ± 0.03 vs 0.21 ± 0.33 mm; P = .01). Changes in wall thickness were greater in the proximal segment of saline-treated
grafts (0.09 ± 0.29 vs 0.00 ± 0.03 mm; P = .04). Increase in maximum graft narrowing was larger in the proximal segment in
the saline-treated grafts (4.7% ± 12.7% vs 0.2% ± 3.8%; P = .01). Nine DuraGraft and 11 saline grafts had occluded or thrombosed. One myocardial
infarction was associated with a saline graft occlusion. No deaths or revascularizations
were observed.
Conclusions
DuraGraft demonstrated a favorable effect on wall thickness at 12 months, particularly
in the proximal segment. Longer-term follow-up in larger studies is needed to evaluate
the effect on clinical outcomes.
Graphical abstract
Graphical Abstract
Key Words
Abbreviations and Acronyms:
CABG (coronary artery bypass grafting), MDCT (multidetector computed tomography), SVG (saphenous vein graft), TVD (total vessel diameter), VGD (vein graft disease), VGF (vein graft failure)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: November 07, 2019
Accepted:
October 21,
2019
Received in revised form:
October 21,
2019
Received:
May 7,
2019
Identification
Copyright
© 2019 by The American Association for Thoracic Surgery
