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Midterm clinical results in myocardial revascularization using the radial artery.

Abstract：

STUDY OBJECTIVES:The aim of this study was to evaluate the immediate and midterm results of coronary artery bypass grafting with the radial artery (RA) as a conduit. PATIENTS:Two hundred forty-one patients underwent myocardial revascularization using the RA. In 78.5% of patients, three coronary vessels were involved, and in 25% of patients, the left main coronary artery was involved. The mean (+/- SD) preoperative ejection fraction was 58 +/- 13%. INTERVENTIONS:The RA was implanted on branches of the circumflex artery in 81% of the cases, and the left internal mammary artery was implanted on the left anterior descending artery in 94% of patients. Total arterial myocardial revascularization was performed in 58% of patients. MEASUREMENTS AND RESULTS:The in-hospital mortality rate was 0.8%. Two patients had acute myocardial infarction, and three patients experienced a transient low-cardiac output syndrome. We reviewed the records of all 171 patients who had undergone at least 6 months of follow-up after surgery. The late mortality rate in this group was 0.6% (one patient died 2 months after surgery because of cardiocirculatory arrest due to untreatable ventricular fibrillation). At a mean follow-up time of 545 +/- 253 days, two patients showed class 3 residual angina according to the Canadian Cardiovascular Society (CCS) guidelines. One patient required another hospital admission 6 months after undergoing surgery for PTCA/stenting on a circumflex artery that had not previously undergone bypass. The second patient, 8 months after undergoing coronary artery bypass grafting, underwent angiography and stenting on a stenosed anastomosis of a posterolateral branch of the circumflex artery that previously had been bypassed with the right internal mammary artery. CONCLUSIONS:The routine use of the RA for coronary bypass grafting is a safe surgical technique, providing excellent clinical mid-term results in terms of cardiac event-free expectancy.

journal_name

Chest

journal_title

Chest

authors

Beghi C,Nicolini F,Budillon AM,Borrello B,Ballore L,Reverberi C,Gherli T

doi

10.1378/chest.122.6.2075

subject

Has Abstract

pub_date

2002-12-01 00:00:00

pages

2075-9

issue

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)50829-5

journal_volume

122

pub_type

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Midterm clinical results in myocardial revascularization using the radial artery.