Key result
Radial artery revascularization is associated with ~92% graft patency and low hospital mortality.
Why the study?
The routine use of the radial artery for coronary artery revascularization and its outcomes in a large patient cohort were not well characterized.
Does myocardial revascularization using the radial artery as a conduit result in safe clinical outcomes and acceptable graft patency in patients requiring coronary artery bypass grafting?
Observational (n=4,000)
Does myocardial revascularization using the radial artery as a conduit result in safe clinical outcomes and acceptable graft patency in patients requiring coronary artery bypass grafting?
Routine use of the radial artery for coronary revascularization is safe, with low hospital mortality and excellent mid-term graft patency.
Radial artery use showed low perioperative mortality in a large observational series; leaves open need for randomized data on long-term outcomes.
Between January 1997 and December 2000, a total of 4,000 patients underwent myocardial revascularization using the radial artery as one of the conduits. The mean age of the patients was 54 +/- 7 years, and 92.8% of them were male. Of these patients, 31% had a left ventricular ejection fraction below 40% and 22.8% underwent urgent operation. A total of 4,225 distal anastomoses were performed using the radial artery. The average number of grafts was 3.3 +/- 0.5. The hospital mortality rate was 0.8%. Low cardiac output, inotropic support, perioperative myocardial infarction, reoperation for bleeding, atrial fibrillation, and sternal infection occurred in 1.8%, 2.8%, 1.2%, 1.2%, 16.8%, and 1.2% of the patients, respectively. None of the patients had major ischemia of the hand. The incidence of local hand wound complications was 0.7% (wound infection, 0.4%; wound dehiscence without infection, 0.1%; and hematoma, 0.2%). The average length of stay in the intensive care unit was 20 +/- 7 hours and in the hospital was 6 +/- 2 days. Postoperative angiography, performed in 106 patients at a mean interval of 18 months, showed that 92.4% of radial artery, 96.2% of internal mammary artery, and 76.2% of saphenous vein grafts were patent.
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Meharwal et al. (2002) conducted an observational in Coronary artery disease requiring revascularization (n=4,000). Radial artery conduit for myocardial revascularization was evaluated on Hospital mortality. Myocardial revascularization using the radial artery was associated with a hospital mortality rate of 0.8% and a radial artery graft patency of 92.4% at 18 months.
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