Details

Autor(en) / Beteiligte

• Acar, Christophe
• Jebara, Victor A.
• Portoghese, Michele
• Beyssen, Bernard
• Pagny, Jean Yves
• Grare, Philippe
• Chachques, Juan C.
• Fabiani, Jean-Noël
• Deloche, Alain
• Guermonprez, Jean Leon
• Carpentier, Alain F.

Titel

Revival of the radial artery for coronary artery bypass grafting

Ist Teil von

• The Annals of thoracic surgery, 1992-10, Vol.54 (4), p.652-660

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

1992

Link zum Volltext

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• Eighteen years after its first introduction for coronary artery revascularization, the radial artery (RA) was reinvestigated because of unexpected good long-term results in the early series. Since July 1989, 104 patients underwent myocardial revascularization using 122 RA grafts (18 patients received two grafts). The left internal mammary artery (IMA) was concomitantly used as a pedicled graft in 100 cases and the right IMA in 19 cases; a free IMA graft was used in 29 cases and a saphenous vein graft in 24 cases. A mean of 2.8 grafts per patient were performed. Nine patients underwent associated procedures: carotid endarterectomy (3), aortic valve replacement (3), Bigelow procedure (1), and mitral valve repair (2). The target artery receiving the RA was the circumflex (n = 59), diagonal (n = 29), right coronary (n = 27), and left anterior descending (n = 7). One patient died (0.96%) and 2 had perioperative myocardial infarct. Sternal wound infection was noted in 3 cases of double IMA implantation. No ischemia of the hand was observed. All patients received diltiazem started intraoperatively and continued after discharge. In addition aspirin (100 mg/day) was given at discharge. Early angiographic controls (<2 weeks) were obtained in the first 50 consecutive patients and revealed 56 of 56 patent RA grafts, 48 of 48 patent left IMA grafts, 11 of 11 patent right IMA grafts, 14 of 18 patent free IMA grafts, and 8 of 9 patent vein grafts. Six patients had localized narrowing of the RA conduit unrelated to the anastomotic lines (spasm). Late angiographic control was obtained after a mean follow-up of 9.2 months in 27 patients; 29 RA grafts were patent (93.5%) and free of spasm and 2 were occluded. This study showed that the RA may be a reasonable alternative to other types of conduits to complement the left IMA.