Increasing interest and use of arterial conduits is based on the better patency of left internal thoracic artery(LITA) than that of saphenous vein(SV) graft. We compared the early result of coronary artery bypass grafting(CABG) using LITA and radial artery(RA group) with CABG using LITA and SV only(SV group).

We compared the early operative results of 6 cases in RA group with 18 cases in SV group selected from 24 cases that had CABG between January 2006 and December 2006. We analyzed each group on the preoperative risk factors and operative results.

We can't find significant differences in clinical and hemodynamic characteristics before surgery. There were no statically significant difference between two groups in operative mortality and each morbidities(postoperative intraaortic balloon pump insertion, bleeding, stroke, perioperative myocardial infarction, wound dehiscence), respectively. However, the overall incidence of conventional CABG using cardiopulmonary bypass was higher in RA group compared to SV group(p=0.016). Accordingly, RA group had longer duration of ventilation time(p=0.004) and ICU stay(p=0.003) than SV group with statically significant difference between two groups in hospital stay. The graft patency on postoperative coronary angiography or computerized tomographic angiography at 7-14 days after operation in both group patients were 100%(includeing LITA, RA and SV).

We had early good operative results in RA group and SV group.

Borine pericardial bioprosthesis fixed in glutaraldehyde(GA) is most popular surgical materials but late calcific degeneration is remained to be solved. To prevent the calcific degeneration, we sdded MgCl₂ into the GA solution to compete with calcium for bending the free aldehyde from GA solution to compete with calcium for binding to the free aldehyde from GA and posttreated with amino acids to enhance the mitigating effect.

40 pieces of bovine pericardia were fixed in 0.625% GA solution with 4g/L MgCl₂ · 6H₂O as a control(group 1). 40 pieces fixde in the same condition were posttreated with 4% chitosan(group 2) and the other 40 pieces posttreated with 8% glutamate(group 3). These were implanted into the belly of 40 Sprague-Dawley subdermally and extracted on 1 month, 2 month, 3 month and 6 months after implantation.

We measured the calcium deposited in those pericardia with atomic absorption spectrophotometry and the results were these ; calcium deposition in group 1 on 1 month after implantation was 0.283±0.059mg/g, 1.338±0.732mg/g in group 2 and 0.469±0.215mg/g in group 3, on the 2nd month 0.921±0.342mg/g in group 1, 6.521±1.919mg/g in group 2 and 2.772±1.747mg/g in group 3, on the 3rd month 0.785±0.212mg/g in group 1, 12.223±3.305mg/g in group 2 and 2.655±0.905mg/g in group 3, and on the 6th month 1.621±1.475mg/g in group 1, 9.121±3.373mg/g in group 2 and 2.916±1.461mg/g in group 3, which have statistical significance(p<0.05).

This means posttreatment with with chitosan or glutamate show no calcium mitigation effects on subcutaneously implanted bovine pericardium in the this experiment which is quite different from others.

Rastelli procedure for right ventricular outflow tract(RVOT) obstruction has many disadvantage especially for children. Instead of using the artificial valved conduit, we applied the REV procedure for preventing the valve re-replacement after growing and observed the fate of that patch.

We performed REV procedure for RVOT reconstruction with our own hand-made monocusp patch composed of porcine pericardial cusp and bovine pericardial patch in 7 young piglets(15.3±1.3kg) and raised till adult pig9about 70 kg). After sacrificed the pig we explored their pulmonary arteries, monocusp patch and hearts.

Without any stenotic residues in the pulmonary artery, we found the deformed monocusp patch with severe calcification, which deprived the adequate valve function, but kept the pig growing normally.

We are sure that this REV procedure with monocusp patch could be extendedly applied to the RVOT obstruction, but we need to develope the anti-calcification method for the heterograft patch.