Radial Artery Graft Use and Off-Pump Coronary Artery Bypass Surgery Outcome

Radial artery is commonly used as a conduit for surgical revascularization. There is scarce data on the effect of radial artery use on outcome following off-pump coronary artery bypass. We prospectively evaluated 591 patients undergoing off-pump coronary artery bypass. Radial artery grafts were used in 398 of these patients (mean age, 67.6 ± 10.4 years; mean follow-up, 37.7 ± 13.4 months). Symptom recurrence (angina, congestive heart failure), adverse cardiac events (myocardial infarction, coronary re-intervention, sudden cardiac death), and overall mortality were recorded. Multivariate Cox regression analysis was used to evaluate predictors of endpoints. Patients with and without radial artery grafts were similar with respect to preoperative risk factors. Recurrent angina developed in 29 patients, congestive heart failure in 5, and myocardial infarction in 9. Coronary arteriography was performed in 27 patients, and 23 underwent re-intervention. Radial artery graft was an independent predictor of increased symptom recurrence and adverse cardiac events. Patients with radial artery grafts also had a tendency towards more angina recurrence, coronary re-intervention, and sudden cardiac death.

[1]  J. Vaage,et al.  Hemostasis in off-pump compared to on-pump coronary artery bypass grafting: a prospective, randomized study. , 2005, The Annals of thoracic surgery.

[2]  A. Salica,et al.  Is postoperative calcium channel blocker therapy needed in patients with radial artery grafts? , 2005, The Journal of thoracic and cardiovascular surgery.

[3]  C David Naylor,et al.  A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts. , 2004, The New England journal of medicine.

[4]  J. Bett,et al.  Five-Year Angiographic Patency of Radial Artery Bypass Grafts , 2004, Circulation.

[5]  M. Lemma,et al.  Is it better to use the radial artery as a composite graft? Clinical and angiographic results of aorto-coronary versus Y-graft. , 2004, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[6]  N. Smedira,et al.  Radial Artery Bypass Grafts Have an Increased Occurrence of Angiographically Severe Stenosis and Occlusion Compared With Left Internal Mammary Arteries and Saphenous Vein Grafts , 2004, Circulation.

[7]  R. Habib,et al.  Improved Survival With Radial Artery Versus Vein Conduits in Coronary Bypass Surgery With Left Internal Thoracic Artery to Left Anterior Descending Artery Grafting , 2004, Circulation.

[8]  J. Pepper,et al.  A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery. , 2004, The New England journal of medicine.

[9]  C. Trani,et al.  Long-Term Results of the Radial Artery Used for Myocardial Revascularization , 2003, Circulation.

[10]  B. Lytle.  Radial versus right internal thoracic artery as a second arterial conduit for coronary surgery: early and midterm outcomes. , 2003, The Journal of thoracic and cardiovascular surgery.

[11]  R. Bellomo,et al.  Radial artery patency and clinical outcomes: five-year interim results of a randomized trial. , 2003, The Journal of thoracic and cardiovascular surgery.

[12]  D. Steinbrüchel,et al.  Platelet function after coronary artery bypass grafting: is there a procoagulant activity after off-pump compared with on-pump surgery? , 2003, Scandinavian cardiovascular journal : SCJ.

[13]  M. di Mauro,et al.  Myocardial revascularization with and without cardiopulmonary bypass in multivessel disease: impact of strategy on midterm outcome. , 2003, The Annals of thoracic surgery.

[14]  Y. Tsutsumi,et al.  Angiographic evaluation of the luminal changes in the radial artery graft in coronary artery bypass surgery: a concern over the long-term patency. , 2002, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[15]  T. Sundt,et al.  Midterm Results of Complete Arterial Revascularization in More Than 1,000 Patients Using an Internal Thoracic Artery/Radial Artery T Graft , 2001, Annals of surgery.

[16]  N. Luciani,et al.  Clinical and Angiographic Effects of Chronic Calcium Channel Blocker Therapy Continued Beyond First Postoperative Year in Patients With Radial Artery Grafts: Results of a Prospective Randomized Investigation , 2001, Circulation.

[17]  M. di Mauro,et al.  Myocardial revascularization with and without cardiopulmonary bypass in multivessel disease: impact of the strategy on early outcome. , 2001, The Annals of thoracic surgery.

[18]  W. van Oeveren,et al.  Procoagulant activity after off-pump coronary operation: is the current anticoagulation adequate? , 1999, The Annals of thoracic surgery.

[19]  A. Calafiore,et al.  Coronary Revascularization with the Radial Artery: New Interest for an Old Conduit , 1995, Journal of cardiac surgery.

[20]  A. Carpentier,et al.  Revival of the radial artery for coronary artery bypass grafting. , 1992, The Annals of thoracic surgery.

[21]  A. Carpentier,et al.  The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts. , 1973, The Annals of thoracic surgery.