Radial Artery as Conduit is Safe and Effective in Coronary Bypass Surgery in the Elderly - Single-Central Results From 326 Patients

被引:17
作者
Chen, Xujun [1 ]
Chen, Xin [1 ]
Xie, Donghua [2 ]
Meng, Fanrong [3 ]
Shi, Kaihu [1 ]
Xu, Ming [1 ]
机构
[1] Nanjing Med Univ, Nanjing Hosp 1, Dept Thorac & Cardiovasc Surg, Jiangsu 210006, Peoples R China
[2] Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA
[3] Nanjing Med Univ, Nanjing Hosp 1, Dept Ultrasound Med, Jiangsu 210006, Peoples R China
关键词
Coronary artery bypass grafting; Elderly; Follow up; Radial artery; ALLEN TEST; MYOCARDIAL REVASCULARIZATION; SAPHENOUS-VEIN; GRAFT FUNCTION; COMPLICATIONS; HARVEST; TRIAL;
D O I
10.1253/circj.CJ-08-1000
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: As an increasing number of aging patients are being referred for coronary artery bypass grafting (CABG), the radial artery (RA) has gained increasing popularity as a conduit. The aim of this study was to investigate the effectiveness of RA in CABG for the elderly with coronary heart disease. Methods and Results: Three hundred and twenty-six elderly patients underwent CABG with RA harvesting between January 2000 and June 2008. A total of 377 RA as grafts were collected. The mean number of distal anastomoses per patient was 3.1 while the mean for RA was 1.1. The operative mortality was 3.1%. Twenty patients developed atrial fibrillation, 7 experienced acute renal failure, 9 had neurological accidents, and 4 had myocardial infarction. There was no ischemic complication on hand. Paresthesia in the donor hand was found in 2 patients. A complete follow up was obtained in 77.2% of patients, with a mean time of 53.5 +/- 35.9 months. RA patency displayed by coronary angiography was 95.83% after a mean time of 74 months of follow up. Conclusions: It was proven to be safe and effective to use RA as a secondary arterial graft after the left internal mammary artery in the elderly patients. (Circ J 2009; 73: 1049-1054)
引用
收藏
页码:1049 / 1054
页数:6
相关论文
共 28 条
[1]   REVIVAL OF THE RADIAL ARTERY FOR CORONARY-ARTERY BYPASS-GRAFTING [J].
ACAR, C ;
JEBARA, VA ;
PORTOGHESE, M ;
BEYSSEN, B ;
PAGNY, JY ;
GRARE, P ;
CHACHQUES, JC ;
FABIANI, JN ;
DELOCHE, A ;
GUERMONPREZ, JL ;
CARPENTIER, AF .
ANNALS OF THORACIC SURGERY, 1992, 54 (04) :652-660
[2]   Preoperative assessment of the radial artery for coronary artery bypass grafting: Is the clinical Allen test adequate? [J].
Agrifoglio, M ;
Dainese, L ;
Pasotti, S ;
Galanti, A ;
Cannata, A ;
Roberto, M ;
Parolari, A ;
Biglioli, P .
ANNALS OF THORACIC SURGERY, 2005, 79 (02) :570-572
[3]   Late results of combined carotid and coronary surgery using actual versus actuarial methodology [J].
Akins, CW ;
Hilgenberg, AD ;
Vlahakes, GJ ;
Madsen, JC ;
MacGillivray, TE ;
LaMuraglia, GM ;
Cambria, RP .
ANNALS OF THORACIC SURGERY, 2005, 80 (06) :2091-2097
[4]   The Allen test [J].
Cable, DG ;
Mullany, CJ ;
Schaff, HV .
ANNALS OF THORACIC SURGERY, 1999, 67 (03) :876-877
[5]   Role of radial artery in total arterial myocardial revascularization in coronary bypass surgery [J].
Chen Xu-Jun ;
Yong, Zhang ;
Xin, Chen ;
Feng Wen-Hui ;
Li Da-Lian ;
Li Hong-Wei .
CHINESE MEDICAL JOURNAL, 2008, 121 (03) :200-204
[6]   Diabetes mellitus as a predictor for radial artery vasoreactivity in patients undergoing coronary artery bypass grafting [J].
Choudhary, Bikrarn P. ;
Antoniades, Charalambos ;
Brading, Alison F. ;
Gallone, Antony ;
Channon, Keith ;
Taggart, David P. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (11) :1047-1053
[7]   Radial artery versus saphenous vein patency randomized trial - Five-year angiographic follow-up [J].
Collins, Peter ;
Webb, Carolyn M. ;
Chong, Chee F. ;
Moat, Neil E. .
CIRCULATION, 2008, 117 (22) :2859-2864
[8]   Radial artery harvesting for coronary bypass operations: Neurologic complications end their potential mechanisms [J].
Denton, TA ;
Trento, L ;
Cohen, M ;
Kass, RM ;
Blanche, C ;
Raissi, S ;
Cheng, W ;
Fontana, GP ;
Trento, A .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2001, 121 (05) :951-956
[9]   Comparative study of harvest-site complications following coronary artery bypass grafting between the radial artery and the saphenous vein in identical patients [J].
Hata, M ;
Shiono, M ;
Sezai, A ;
Iida, M ;
Saitoh, A ;
Hattori, T ;
Wakui, S ;
Soeda, M ;
Negishi, N ;
Sezai, Y .
SURGERY TODAY, 2005, 35 (09) :711-713
[10]   Which arterial conduit? Radial artery versus free right internal thoracic artery: Six-year clinical results of a randomized controlled trial [J].
Hayward, Philip A. R. ;
Hare, David L. ;
Gordon, Ian ;
Matalanis, George ;
Buxton, Brian F. .
ANNALS OF THORACIC SURGERY, 2007, 84 (02) :493-497