title: Occurrence of myocardial ischemia immediately after coronary revascularization using radial arterial conduits.
abstract: OBJECTIVE
  To assess the incidence of myocardial ischemia in patients receiving radial arterial and left internal thoracic arterial conduits (RA+LITA) during the postrevascularization period.
  
  
  METHODS
  Nonrandomized observational sequential cohort.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Thirty adult patients, scheduled for elective coronary artery bypass graft surgery with RA+LITA, compared with 30 patients who received saphenous vein graft and left internal thoracic arterial conduits.
  
  
  METHODS
  None.
  
  
  RESULTS
  Myocardial ischemic episodes were defined as reversible ST-segment depressions or elevations >or=1 mm and >or=2 mm at J +60 msec and lasting >or=1 minute using 2-channel Holter monitoring. During the post-cardiopulmonary bypass period, a significantly higher number of patients with >or=2 mm ischemic episodes (21.7%; p = 0.015) and higher number of >or=2 mm ischemic episodes per hour (0.19 +/- 0.4 episodes/hr; p = 0.03) were observed in the radial artery group versus the comparison group (0% of patients and 0 episodes/hr). During the postoperative period (24 hours), a significantly longer duration of >or=2 mm ischemic episodes was observed in the radial artery group (24 +/- 33 minutes v 8.4 +/- 21 minutes; p = 0.046). Radial artery graft, preoperative calcium antagonists, and pulmonary arterial mean pressure were independent predictors of the duration and area under the ST-segment curve of >or=2 mm ischemic episodes during the postoperative period.
  
  
  CONCLUSIONS
  There is an association between the use of the radial artery graft and the incidence and severity of >or=2 mm postrevascularization ischemic episodes.
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesia, Washington University School of Medicine, St. Louis, MO 63110, USA. apostoli@notes.wustl.edu
authors.forename: I A
authors.initials: IA
authors.lastname: Apostolidou
authors.forename: N J
authors.initials: NJ
authors.lastname: Skubas
authors.forename: G J
authors.initials: GJ
authors.lastname: Despotis
authors.forename: E
authors.initials: E
authors.lastname: Kallinteri
authors.forename: C W
authors.initials: CW
authors.lastname: Hogue
authors.forename: D G
authors.initials: DG
authors.lastname: Lappas
authors.forename: H B
authors.initials: HB
authors.lastname: Barner
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000175:diagnosis; D017534:Radial Artery / Q000637:transplantation; D012501:Saphenous Vein / Q000637:transplantation