title: Midterm clinical results in myocardial revascularization using the radial artery.
abstract: OBJECTIVE
  The aim of this study was to evaluate the immediate and midterm results of coronary artery bypass grafting with the radial artery (RA) as a conduit.
  
  
  METHODS
  Two hundred forty-one patients underwent myocardial revascularization using the RA. In 78.5% of patients, three coronary vessels were involved, and in 25% of patients, the left main coronary artery was involved. The mean (+/- SD) preoperative ejection fraction was 58 +/- 13%.
  
  
  METHODS
  The RA was implanted on branches of the circumflex artery in 81% of the cases, and the left internal mammary artery was implanted on the left anterior descending artery in 94% of patients. Total arterial myocardial revascularization was performed in 58% of patients.
  
  
  RESULTS
  The in-hospital mortality rate was 0.8%. Two patients had acute myocardial infarction, and three patients experienced a transient low-cardiac output syndrome. We reviewed the records of all 171 patients who had undergone at least 6 months of follow-up after surgery. The late mortality rate in this group was 0.6% (one patient died 2 months after surgery because of cardiocirculatory arrest due to untreatable ventricular fibrillation). At a mean follow-up time of 545 +/- 253 days, two patients showed class 3 residual angina according to the Canadian Cardiovascular Society (CCS) guidelines. One patient required another hospital admission 6 months after undergoing surgery for PTCA/stenting on a circumflex artery that had not previously undergone bypass. The second patient, 8 months after undergoing coronary artery bypass grafting, underwent angiography and stenting on a stenosed anastomosis of a posterolateral branch of the circumflex artery that previously had been bypassed with the right internal mammary artery.
  
  
  CONCLUSIONS
  The routine use of the RA for coronary bypass grafting is a safe surgical technique, providing excellent clinical mid-term results in terms of cardiac event-free expectancy.
authors.affiliation: Cardiac Surgery Department, University of Parma, Via A. Gramsci 14, 43100 Parma, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Beghi
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicolini
authors.forename: Alessandro Maria
authors.initials: AM
authors.lastname: Budillon
authors.forename: Bruno
authors.initials: B
authors.lastname: Borrello
authors.forename: Luca
authors.initials: L
authors.lastname: Ballore
authors.forename: Claudio
authors.initials: C
authors.lastname: Reverberi
authors.forename: Tiziano
authors.initials: T
authors.lastname: Gherli
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D013318:Stroke Volume; D016896:Treatment Outcome