Feasibility and short-term results of total arterial coronary artery bypass in Taiwanese.
OBJECTIVE
Long-term results of coronary artery bypass are limited by progressive atherosclerosis in venous conduits. Arterial conduits are believed to have a better patency rate. A radial artery in composite graft with the left internal thoracic artery makes total arterial revascularization possible in almost all patients. We sought to evaluate the feasibility and short-term results of this grafting strategy.


METHODS
A total of 381 consecutive patients received elective coronary artery bypass grafting between 1 May 2000 and 31 August 2002. Patients with associated procedures were also included. There were 333 patients without venous conduits. Patients with left ventricular dysfunction were not excluded from total arterial revascularization. Follow-up time was 13.7 +/- 7.6 months.


RESULTS
Total arterial revascularization was achieved in 88% of the patients. Arterial harvest was easy and simple and complete revascularization could be achieved. The 30-day overall mortality rate was 3.29%. In the patients with left ventricle ejection fraction greater than 0.4, the mortality rate was 2.32%. There were 6 late deaths: heart failure in 2, sepsis in 2, respiratory failure in 1, and pneumonia in 1.


CONCLUSIONS
It is feasible to use total arterial grafts for coronary artery bypass graft in patients with coronary artery disease. Myocardial revascularization can be complete and the early mortality rate is acceptable.
Cardiovascular Division of Surgery, Taichung Veterans General Hospital, Taichung City, Taiwan and College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Hao-Ji
HJ
Wei
Chung-Chi
CC
Wang
Shih-Rong
SR
Hsieh
Hung-Wen
HW
Tsai
Yen
Y
Chang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013624:Taiwan; D013895:Thoracic Arteries / Q000601:surgery*; D016896:Treatment Outcome; D014654:Vascular Patency