Early Result of Proximal Anastomosis Methods of Radial Artery in Coronary Artery Bypass Surgery

Park, Jong Un; Chee, Hyun Keun; Shin, Yoon Cheol; Kim, Eung Jung

Abstract

BACKGROUND: There are many different opinions regarding the proximal anastomotic sites of radial artery in coronary artery bypass surgery. Therefore, we compared the clinical and angiographic findings according to anastomosis of radial artery to develop a guideline. MATERIAL AND METHOD: From January 2003 to December 2004, 48 patients who underwent coronary artery bypass surgery using radial artery in Kangdong Sacred Heart Hospital were studied for clinical and coronary angiographic findings and were divided into group I for radial artery that anastomsed to aorta independently and group II that anastomosed to left internal mammary artery. RESULT: Patients in group I were 33 (men 26, women 7; mean age 61.93+/-6.56) and group II were 15 (men 13, women 2; mean age 59.53+/-6.02) and there was no difference in preoperative characteristics. Patients in group I had longer cardiopulmonary bypass time (169.36+/-40.28 versus 139.40+/-20.45, p=0.026) and patients in group II had more sequential grafts with RA per patients (5/33 versus 11/15, p <0.05). Patients in group I used more vein graft for distal anatstomosis (47/117 (40%) versus 9/48 (18%), p=0.011) and there was no difference in perioperative outcome and overall survival. Mean follow-up time was 15.87+/-7.33 (1 to 28) months in patients of the group I and 21.40+/-2.85 (17 to 25) months in group II. Postoperative coronary angiography was performed 17/33 (51.5%) in group I and 14/15 (93.3%) in group II. Early perfect patency rate was not statistically different in left anterior descending artery (15/17 (88.2%) versus 2/14 (85.7%), p=1.00) and radial artery (17/20 (85%) versus 30/30 (100%), p=0.058). Late mortality was 1/33 (3.0%) in group I and 1/15 (6.7%) in group II.
CONCLUSION
There was no difference in terms of clinical and postoperative angiographic findings except in cardiopulmonary bypass time, the number of sequential grafts with the RA per patients and the number of the used vein graft.