Details

Autor(en) / Beteiligte

• Achouh, Paul, MD
• Boutekadjirt, Redha, MD
• Toledano, Daniel, MD
• Hammoudi, Nadjib, MD
• Pagny, Jean-Yves, MD
• Goube, Pascal, MD
• Isselmou, Khaled Ould, MD
• Lancelin, Bernard, MD
• Fouquet, Régis, MD
• Acar, Christophe, MD

Titel

Long-term (5- to 20-year) patency of the radial artery for coronary bypass grafting

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2010-07, Vol.140 (1), p.73-79.e2

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2010

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective The aim of this study was to assess the angiographic results of the radial artery as a coronary bypass conduit at long term (>5 years). Methods Radial artery grafts were controlled in 202 patients at 10.1 years by conventional angiography (n = 79) and computed tomography (n = 123). Clinical or paraclinical evidence of ischemia was noted in 81 patients, whereas 121 patients were asymptomatic. Some 520 conduits were controlled: radial artery (n = 230), left internal thoracic artery (n = 190), right internal thoracic artery (n = 30), and veins (n = 70). Radial arteries were anastomosed to the right coronary (24%), marginal (58%), diagonal (16%), and left anterior descending (<1%) arteries, whereas left internal thoracic arteries were primarily anastomosed to the left anterior descending artery (95%). The mean number of antithrombotic and anti-anginal medications was 1.2 and 1.9 per patient, respectively. Results The ejection fraction was slightly decreased compared with its preoperative value (54% ± 11% vs 57% ± 9%; P = .009). Nine reoperations were required at 10.5 years for valve replacement (n = 8) and isolated bypass (n = 1). Percutaneous intervention was performed in 48 patients (24%) at 7.6 years on a graft (28%) or a native coronary artery (72%). The 10-year patency of radial artery grafts was 83%, which was lower than the patency of left internal thoracic arteries (95%, P < . 001) and similar to the patency of right internal thoracic arteries (87%, P = .66) and veins (81%, P = .50). No medication seemed to influence radial artery graft patency (aspirin: P = .26; calcium blockers: P = .36). All graft patency was lower when clinical or paraclinical evidence of ischemia was present than in asymptomatic cases (83% vs 90% P = .02). The patency of left anterior descending grafts was higher than that of non-left anterior descending grafts (96% vs 82% P < . 001). Conclusion The radial artery-to-coronary bypass conduit provided a low coronary reoperation rate with an excellent patency (83%) up to 20 years postoperatively.