Radial artery 2000--risk analysis of mortality for coronary bypass surgery with radial artery.
BACKGROUND
The aim of this study is to review our experience with using more than 2,000 RAs over the last seven years, and to assess the medium-term outcome in terms of morbidity and mortality.


METHODS
Between June 1994 and June 2001, a total of 2,024 RAs have been used in 1,613 patients. The mean duration of follow-up was 40.1 months and ranged from one to 88 months. We assessed the results of postoperative mortality and morbidity, RA graft patency, coronary event free rate, and actuarial survival rate. Specifically, the independent predictors of early and late mortalities were examined.


RESULTS
Perioperative myocardial infarction was indicated in 0.8%, stroke in 1.6%, respectively. Overall hospital mortality was 35 patients (2.4%). RA patency rate was 98.1%. Coronary event free rate and actuarial survival rates at seven years were 99.6% and 95.1%, respectively. Multivariate logistic regression analysis detected an ejection fraction of less than 30% (p=0.0009), re-exploration (p=0.02), and stroke (p=0.03) as significant independent predictors of operative mortality. The use of saphenous vein graft (p=0.0417) and renal impairment (p=0.0045) were significant independent predictors of late mortality.


CONCLUSIONS
Our seven-year experience of CABG with RA suggested that the use of RA was safe and had excellent results in postoperative graft patency and low incidence of complications. This study suggested that the use of RA instead of the saphenous vein graft made a better outcome for late survival in the patients undergoing CABG.
Hata
Mitsumasa
M
Department of Cardiac Surgery, Austin and Repatriation Medical Centre, University of Melbourne, Melbourne, Australia.
Seevanayagam
Siven
S
Manson
Narelle
N
Rosalion
Alexander
A
Matalanis
George
G
Raman
Jai
J
Buxton
Brian F
BF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014654:Vascular Patency