The radial artery for coronary artery bypass grafting: clinical and angiographic results at five years
| Autor: | Jean-Yves Pagny, Alain Carpentier, Pascal Barrier, Christophe Acar, Jean-Léon Guermonprez, Victor A. Jebara, Jean-Noël Fabiani, Amhad Ramsheyi, Alain Deloche |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Percutaneous Coronary Disease Coronary Angiography Angina Electrocardiography Postoperative Complications Recurrence Internal medicine medicine.artery medicine Humans Derivation Circumflex Radial artery Coronary Artery Bypass Mammary Arteries Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Anticoagulants Middle Aged medicine.disease Surgery Transplantation Survival Rate medicine.anatomical_structure Treatment Outcome Angiography Radial Artery Cardiology business Cardiology and Cardiovascular Medicine Platelet Aggregation Inhibitors Artery Follow-Up Studies |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 116(6) |
| ISSN: | 0022-5223 |
| Popis: | Objective: The aim of this study was to assess the long-term results of use of the radial artery as a conduit for coronary artery bypass grafting. Methods : After revival of the technique in 1989, the radial artery was used as a conduit in 910 patients undergoing coronary artery bypass grafting. A complete follow-up was obtained for the first 102 consecutive patients from 4 to 7 years after the operation (mean 5.27 ± 1.30 years). Fifty-nine percent of the patients were receiving calcium-channel inhibitors. An electrocardiographic stress test was obtained for 51 patients, with no contraindications found. Routine follow-up angiography was performed in 50 cases, including those of all patients with symptoms. Thus 64 radial artery and 48 left internal thoracic artery grafts were followed up from 4 to 7 years after the operation (mean 5.6 ± 1.40 years). Results: The actuarial survival was 91.6% at 5 years, and the actuarial rate of freedom from angina was 88.7% at 5 years. Four patients underwent percutaneous transluminal angioplasty during the period of follow-up, and there were no reoperations for revision of the bypass. The electrocardiographic stress test showed negative results in 73% of cases, electrocardiographic changes alone in 21%, and clinically positive results in 6%. Angiography showed that the patency rate of the radial artery grafts was 83%. The patency rate of the left internal thoracic artery grafts (n = 47) was 91%. The difference in patency could be related to the implantation sites of the grafts, mainly the circumflex artery (51%) for the radial artery grafts and almost exclusively the left anterior descending artery (94%) for the left internal thoracic artery. Conclusion: The use of the radial artery for coronary bypass grafting provides excellent clinical and angiographic results at 5 years. Routine use of the radial artery in combination with the left internal thoracic artery can be recommended. (J Thorac Cardiovasc Surg 1998;116: 981-9) |
| Databáze: | OpenAIRE |
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