Myocardial revascularization with radial and mammary arteries: initial and mid-term results.
BACKGROUND
The radial artery is being used with increasing frequency instead of the saphenous vein in coronary artery bypass grafts. We analyzed the in-hospital and midterm results in patients undergoing coronary artery bypass surgery in whom a combination of arterial grafts was used, including radial artery and one or both internal mammary arteries.


METHODS
Between 1995 and 1998, 1,023 patients underwent coronary artery bypass surgery using arterial conduits. The left internal mammary artery and the right internal mammary artery were employed in combination with the radial artery.


RESULTS
An average of 3.2 grafts per patient were done. The left internal mammary artery and radial artery were used in 100% of patients, the right internal mammary artery in 21.7%, and a venous graft in 31%. The operative mortality rate was 2.5%. On repeat angiography performed in 62 patients before their discharge, the arterial conduits were patent in 98.4%. Mean follow-up was 25.0 +/- 9.6 months (1 to 48 months). The probability of survival was 92.8%.


CONCLUSIONS
Revascularization using mammary and radial artery grafts is safe. Complications are not higher than those observed with saphenous vein grafting. It was possible to use arterial conduits in all the patients, even in those with impaired left ventricular function.
Weinschelbaum
E E
EE
Department of Cardiovascular Surgery, Institute of Cardiology and Cardiovascular Surgery, Favaloro Foundation, Buenos Aires, Argentina. ew@datamarkets.com.ar
Macchia
A
A
Caramutti
V M
VM
Machain
H A
HA
Raffaelli
H A
HA
Favaloro
M R
MR
Favaloro
R R
RR
Dulbecco
E A
EA
Abud
J A
JA
De Laurentiis
M
M
Gabe
E D
ED
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D017534:Radial Artery / Q000637:transplantation*; D015996:Survival Rate