[Two-years experience with the use of radial artery in coronary revascularization surgery].
BACKGROUND
Among several other factors, in coronary surgery the results depend on the quality and durability of the grafts. Revascularization employing arterial conduits, namely the radial artery, has been playing a growing role, with the aim of replacing the autologous saphenous vein. The benefits and risks of this strategy is still a matter of controversy. The goal of the present study was the evaluation of the incidence of early complications related to the use of radial artery in the revascularization surgery of the myocardium.


METHODS
A series of consecutive patients who underwent coronary revascularization surgery in the CHVNGaia using radial artery, from January 2000 to December 2001, was retrospectively analyzed. Data were obtained through the revision of the clinical charts and hospital database. The major end-point assessed was the 30-day or intra hospital postoperative death; furthermore, acute myocardial infarction, stroke, renal failure, prolonged ventilation and reoperations for acute graft occlusion, bleeding and mediastistinitis were also evaluated.


RESULTS
During that period of time, 656 patients underwent coronary revascularization surgery, but the radial artery was used in only 230 (35%). Mean age was 60.2+/- 9.1 years and 42 (18.3%) were female. Two hundred and four patients (88.6%) were operated on under extracorporeal circulation. The average number of grafts was 2.6+/- 0.6 per patient. Mean duration of orotraqueal intubation was 2.4 +/- 6 hours. Thirty patients (14,3 %) developed atrial fibrillation and ten (4.3%) had postoperative bleeding. Perioperative myocardial infarction occurred in five cases (2.2%). Two patients (0.8%) underwent reoperation for mediastinitis and one patient (0.4%) was reoperated on for acute occlusion of the graft. The overall postoperative mortality was 1.3% (3 patients).


CONCLUSIONS
The use of radial artery in coronary revascularization did not caused morbidity and mortality, out of the usual context of coronary surgery. The results of our experience suggest that radial artery can be successfully used in myocardial revascularization surgery, enlarging the possibilities of utilization of arterial autografts.
Carneiro
F
F
Serviço de Cirurgia Cardio-Torácica Centro Hospitalar de Vila Nova de Gaia, Portugal.
Mota
J C
JC
Miranda
J
J
Ponce
P
P
Vieira
M
M
Guerreiro
M
M
Vouga
L
L
D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D017534:Radial Artery / Q000637:transplantation*; D012189:Retrospective Studies; D013997:Time Factors