A groundbreaking study led by the Royal Melbourne Hospital and the University of Melbourne has found that coronary bypass surgery using arteries instead of vein grafts can lead to longer lives for patients.

The medical research, published in the prestigious Journal of the American College of Cardiology (JACC), reviewed data from over 250,000 matched patients and found that those who had bypass surgery without using saphenous vein grafts had a 23% lower risk of death over an 8-year period.

Saphenous vein grafts (SVG) are commonly used in bypass surgery. A SVG is a vein that is taken from the leg and used to bypass a blocked or narrowed artery in the heart during a surgery called coronary artery bypass surgery.

The study found that these grafts can develop progressive and accelerated disease, leading to them blocking and causing complications in 50% of cases in the 10 years following surgery.

Cardiothoracic surgeon at the Royal Melbourne Hospital (RMH) and lead author of the study Professor Alistair Royse said the research found that exclusively using arterial conduits instead of saphenous vein grafts in bypass surgery can lead to better long-term survival outcomes for patients.

“Essentially what we found is that if an artery is working, there is no evidence of disease, but most vein grafts develop disease, which may eventually lead to their failure.

“We believe that these findings have the potential to change the way bypass surgery is performed worldwide, and could potentially save thousands of lives each year,” Professor Royse said.

The RMH has a history of using arterial grafts, which has been part of standard practice since the mid-1990s.

The findings are a significant breakthrough in the treatment of heart disease and have led to further $5 million research grant by the federal government Medical Research Future (MRFF).

The $5 million will be used to complete a randomised Australia wide multicentre trial, called the “TA” trial.

“The JACC paper was not a prospective randomised trial, which means it does not provide the definitive answer, so this grant will allow us to prove what this research has found, by funding the first randomised study in this field in Australia,” Professor Royse said.

The trial is set to start later this year.

Mobile Stroke Unit with Ambulance Victoria paramedic and the RMH Stroke team
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