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Ann Thorac Cardiovasc Surg. 2018 Aug 17. doi: 10.5761/atcs.oa.18-00054. [Epub ahead of print]

The Risk Factor Analysis for the Late Graft Failure of Radial Artery Graft in Coronary Artery Bypass Grafting.

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1
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan.

Abstract

OBJECTIVE:

The aim of this retrospective study was to investigate the early operative results and detect the factors influencing the fate of radial artery grafts (RAGs) by evaluating the mid-term patency.

METHODS:

We retrospectively reviewed 410 patients who underwent isolated coronary artery bypass grafting using RAG. RAGs were anastomosed to 526 coronary arteries. Mid-term angiography was performed in 214 patients at an average 4.9 years after the operation.

RESULTS:

The early patency of RAGs was 97.6%. Cumulative 5-year patency was 86.5% for RAG, 94.1% for LITA graft, and 81.0% for saphenous vein graft (SVG). RAG was significantly superior to SVG in mid-term patency. Individual grafting (not sequential grafting) (hazard ratio [HR]: 2.535; 95% confidence interval [CI]: 1.293-5.281; p = 0.006) and grafting to the target coronary artery with ≤75% proximal stenosis (HR: 1.947; 95% CI: 1.090-3.484; p = 0.025) were found to be independent risk factors influencing late RAG patency.

CONCLUSIONS:

The patency of RAGs was superior to that of SVGs in the studied population. When using RAGs, grafting to the target vessel with severe proximal stenosis is favorable. The RAG is suitable for sequential grafting.

KEYWORDS:

coronary artery bypass grafting; graft patency; radial artery graft

PMID:
30122739
DOI:
10.5761/atcs.oa.18-00054
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