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Clinical Investigations: CARDIOLOGY |

Midterm Clinical Results in Myocardial Revascularization Using the Radial Artery*

Cesare Beghi, MD; Francesco Nicolini, MD; Alessandro Maria Budillon, MD; Bruno Borrello, MD; Luca Ballore, MD; Claudio Reverberi, MD; Tiziano Gherli, MD
Author and Funding Information

Cardiac Surgery Department, University of Parma, Parma, Italy.

Correspondence to: Francesco Nicolini, MD, Divisione e Cattedra di Cardiochirurgia, Università degli Studi, Via A. Gramsci, 14, 43100 Parma, Italy; e-mail: francesco.nicolini@unipr.it



Chest. 2002;122(6):2075-2079. doi:10.1378/chest.122.6.2075
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Study objectives: The aim of this study was to evaluate the immediate and midterm results of coronary artery bypass grafting with the radial artery (RA) as a conduit.

Patients: Two hundred forty-one patients underwent myocardial revascularization using the RA. In 78.5% of patients, three coronary vessels were involved, and in 25% of patients, the left main coronary artery was involved. The mean (± SD) preoperative ejection fraction was 58 ± 13%.

Interventions: The RA was implanted on branches of the circumflex artery in 81% of the cases, and the left internal mammary artery was implanted on the left anterior descending artery in 94% of patients. Total arterial myocardial revascularization was performed in 58% of patients.

Measurements and results: The in-hospital mortality rate was 0.8%. Two patients had acute myocardial infarction, and three patients experienced a transient low-cardiac output syndrome. We reviewed the records of all 171 patients who had undergone at least 6 months of follow-up after surgery. The late mortality rate in this group was 0.6% (one patient died 2 months after surgery because of cardiocirculatory arrest due to untreatable ventricular fibrillation). At a mean follow-up time of 545 ± 253 days, two patients showed class 3 residual angina according to the Canadian Cardiovascular Society (CCS) guidelines. One patient required another hospital admission 6 months after undergoing surgery for PTCA/stenting on a circumflex artery that had not previously undergone bypass. The second patient, 8 months after undergoing coronary artery bypass grafting, underwent angiography and stenting on a stenosed anastomosis of a posterolateral branch of the circumflex artery that previously had been bypassed with the right internal mammary artery.

Conclusions: The routine use of the RA for coronary bypass grafting is a safe surgical technique, providing excellent clinical mid-term results in terms of cardiac event-free expectancy.


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