title: Coronary artery bypass grafting using the radial artery: influence of proximal anastomosis site in mid-term and long-term graft patency.
abstract: OBJECTIVE
  To determine whether the proximal anastomosis interferes or not in mid- and long-term patency of these grafts.
  
  
  METHODS
  One hundred twenty-three out of 481 patients who had undergone surgery using radial artery (RA) were restudied. The mean age was 58.8 + 10.4 years. In 96 (78.05%) patients the cardiopulmonary bypass (CPB) was used. Considering all surgical grafts, 382 coronary branches were grafted (mean, 3.1 + 0.8 arteries per patient). 150 of them used radial artery (RA), and the left marginal branches (LOM) were the most prevalent (48.67%). The proximal anastomosis was performed in the aorta in 50 (40.65%) patients and as an artificial 'Y' composite graft with the left or right internal thoracic artery (LIMA/RITA) in 73 (59.35%). Postoperatively, coronary angiography studies were performed within a mean period of 5.36 + 3.21 years. The obtained data was divided into two categories: proximal anastomosis (aorta/composite) and patency (occluded/patent). A chi-square test was used to compare both proportions, within a 95% confidence interval (CI).
  
  
  RESULTS
  From the 50 aorta-anastomosed grafts, 42 (84%) were patent and eight (16%) occluded. Regarding the 73 'Y' composite grafts, 59 (80.82%) were patent and 14 (19.18%) occluded. Comparing these proportions in both techniques, there was no statistically significant difference between them (P=0.651, CI=95%).
  
  
  CONCLUSIONS
  The site of proximal anastomosis of the RA coronary grafts does not interfere in mid- and long-term graft occlusion and patency.
authors.affiliation: Heart Institute of Clinics Hospital ofFaculty of Medicine, University of São Paulo (InCor-HCFMUSP), São Paulo, Brazil. luciano.carneiro@superig.com.br
authors.forename: Luciano Jannuzzi
authors.initials: LJ
authors.lastname: Carneiro
authors.forename: Fernando
authors.initials: F
authors.lastname: Platania
authors.forename: Luís Augusto Palma
authors.initials: LA
authors.lastname: Dallan
authors.forename: Luís Alberto Oliveira
authors.initials: LA
authors.lastname: Dallan
authors.forename: Noedir Antonio Groppo
authors.initials: NA
authors.lastname: Stolf
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D001011:Aorta / Q000601:surgery*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000601:surgery*; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D014654:Vascular Patency / Q000502:physiology*