Perioperative Outcomes of Coronary Artery Bypass Grafting Using the Radial Artery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Renteng , JIANG Hui , WANG Huishan , WU Haibo , LIU Tao.

Department of Cardiovascular Surgery，General Hospital of Shenyang Military Command，Shenyang 110016，P. R. China;

Corresponding author：

Keywords：

Coronary artery bypass grafting; 　Radial artery; 　Great saphenous vein; 　Cardiovascular event

DOI：

10.7507/1007-4848.20130169

Video：

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Objective To explore perioperative outcomes of coronary artery bypass grafting （CABG） using the radialartery as the second arterial graft. Methods Clinical data of 175 consecutive patients undergoing off-pump coronary artery bypass grafting （OPCAB） in General Hospital of Shenyang Military Command from August 2011 to April 2012 were retrospectively analyzed. All the 175 patients were divided into two groups. There were 75 patients including 49 male and 26 female patients with their age of 56.8±8.2 years in group 1，who received radial artery as a graft vessel. There were 100patients including 66 male and 34 female patients with their age of 57.7±8.1 years in group 2，who received great saphenousvein but not radial artery as the graft vessel. The use of left internal mammary artery as a graft vessel was 100% in both groups. Perioperative cardiovascular events and other clinical results were compared between the two groups. Results All the patients survived OPCAB and there was no 30-day death. There was no statistical difference in operation time，thoracic drainage within the first 24 hours after surgery or postoperative hospital stay between the two groups（P＞0.05）. Length of postoperative ICU stay and mechanical ventilation time of group 1 were shorter than those of group 2，although the differencewas not statistically significant. The percentage of patients receiving prolonged postoperative inotropic therapy of group 2 was higher than that of group 1 ［16% （16/100） vs. 12% （9/75）］，although the difference was not statistically significant. Postoperatively，there was no patient in group 1 who had new-onset myocardial ischemia or received intra-aortic balloon pump （IABP） support for hemodynamic instability. In group 2，3 patients had new-onset myocardial ischemia and 2 patientsreceived IABP support after OPCAB. Conclusion Radial artery can partly replace great saphenous vein as a graft vesselfor OPCAB，which does not increase the risk of perioperative cardiovascular events but is beneficial for postoperativerecovery to some degree. Radial artery can be more extensively used in CABG.

Citation： ZHANG Renteng,JIANG Hui,WANG Huishan,WU Haibo,LIU Tao.. Perioperative Outcomes of Coronary Artery Bypass Grafting Using the Radial Artery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(5): 538-541. doi: 10.7507/1007-4848.20130169 Copy

1.	Tatoulis J， Royse AG， Buxton BF， et al. The radial artery in coronarysurgery：a 5-year experience—clinical and angiographic results. Ann Thorac Surg， 2002， 73 （1）：143-147.
2.	Tagusari O， Kobayashi J， Bando K， et al. Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system：clinical outcome and angiographic evaluation. Ann Thorac Surg， 2004， 78 （4）：1304-1311.
3.	Pola P， Serricchio M， Flore R， et al. Safe removal of the radial artery for myocardial revascularization：a Doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg， 1996， 112 （3）：737-744.
4.	吴强，黄方炯，孙东，等. 冠状动脉旁路移植手术后不同移植血管远期通畅率. 中华实用诊断与治疗杂志， 2010， 24 （11）：1072-1074.
5.	Loop FD， Lytle BW， Cosgrove DM， et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med， 1986， 314 （1）：1-6.
6.	祝岩，谷天祥，李新民，等. 硝酸甘油、维拉帕米和罂粟碱缓解人桡动脉痉挛的研究. 中国胸心血管外科临床杂志， 2007， 14 （4）：261-265.
7.	Muneretto C， Negri A， Manfredi J， et al. Safety and usefulness of composite grafts for total arterial myocardial revascularization：aprospective randomized evaluation. J Thorac Cardiovasc Surg， 2003，125 （4）：826-835.
8.	Desai ND， Cohen EA， Naylor CD， et al. A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts. N Engl J Med， 2004， 351 （22）：2302-2309.
9.	Nakajima H， Kobayashi J， Funatsu T， et al. Predictive factors for the intermediate-term patency of arterial grafts in aorta no-touchoff-pump coronary revascularization. Eur J Cardiothorac Surg， 2007， 32 （5）：711-717.
10.	Briguori C， Testa U， Riccioni R， et al. Correlations between prog-ression of coronary artery disease and circulating endothelial progen-itorcells. FASEB J， 2010 24 （6）：1981-1988.
11.	Verhoeffb J， Siebes M， Meuwissen M， et al. Influence of percutaneous coronary intervention on coronary microvas-cular resistance index. Circulation， 2005， 111 （1）：76-82.
12.	Collins P， Webb CM， Chong CF， et al. Radial artery versus saphenousvein patency randomized trial：five-year angiographic follow-up. Circulation， 2008， 117 （22）：2859-2864.
13.	Possati G， Gaudino M， Prati F， et al. Long-term results of the radial artery used for myocardial revascularization. Circulation， 2003， 108 （11）：1350-1354.
14.	Tatoulis J， Buxton BF， Fuller JA， et al. Long-term patency of 1108 radial arterial-coronary angiograms over 10 years. Ann Thorac Surg， 2009， 88 （1）：23-29.
15.	Buxton BF， Raman JS， Ruengsakulrach P， et al. Radial artery patency and clinical outcomes：five-year interim results of a randomizedtrial. J Thorac Cardiovasc Surg， 2003， 125 （6）：1363-1371.
16.	Achouh P， Boutekadjirt R， Toledano D， et al. Long-term （5-to 20-year） patency of the radial artery for coronary bypass grafting. J Thorac Cardiovasc Surg， 2010， 140 （1）：73-79.
17.	邓勇志，孙宗全. 桡动脉在冠状动脉旁路移植术中的应用. 中国胸心血管外科临床杂志， 2007， 14 （4）：297-302.
18.	Loop F， Lytle BW， Cosgrove DM， et al. Sternal wound complications after isolated coronary bypass grafting：early and late mortality， morbidity， and cost of care. Ann Thorac Surg， 1990， 49 （2）：179-186.
19.	Grossi EA， Esposito R， Harris LJ， et al. Sternal wound infections and use of internal mammary artery grafts. Ann Thorac Surg， 1991， 102 （3）：342-347.
20.	Zacharias A， Habib RH. Factors predisposing to median sternotomy complications. Deep vs superficial infection.Chest， 1996， 110 （5）：1173-1178.
21.	杭钧彪，孔烨，周健，等. 全动脉化非体外循环下冠状动脉旁路移植66例分析. 南方医科大学学报， 2010， 30 （10）：2411-2412.

1. Tatoulis J， Royse AG， Buxton BF， et al. The radial artery in coronarysurgery：a 5-year experience—clinical and angiographic results. Ann Thorac Surg， 2002， 73 （1）：143-147.
2. Tagusari O， Kobayashi J， Bando K， et al. Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system：clinical outcome and angiographic evaluation. Ann Thorac Surg， 2004， 78 （4）：1304-1311.
3. Pola P， Serricchio M， Flore R， et al. Safe removal of the radial artery for myocardial revascularization：a Doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg， 1996， 112 （3）：737-744.
4. 吴强，黄方炯，孙东，等. 冠状动脉旁路移植手术后不同移植血管远期通畅率. 中华实用诊断与治疗杂志， 2010， 24 （11）：1072-1074.
5. Loop FD， Lytle BW， Cosgrove DM， et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med， 1986， 314 （1）：1-6.
6. 祝岩，谷天祥，李新民，等. 硝酸甘油、维拉帕米和罂粟碱缓解人桡动脉痉挛的研究. 中国胸心血管外科临床杂志， 2007， 14 （4）：261-265.
7. Muneretto C， Negri A， Manfredi J， et al. Safety and usefulness of composite grafts for total arterial myocardial revascularization：aprospective randomized evaluation. J Thorac Cardiovasc Surg， 2003，125 （4）：826-835.
8. Desai ND， Cohen EA， Naylor CD， et al. A randomized comparison of radial-artery and saphenous-vein coronary bypass grafts. N Engl J Med， 2004， 351 （22）：2302-2309.
9. Nakajima H， Kobayashi J， Funatsu T， et al. Predictive factors for the intermediate-term patency of arterial grafts in aorta no-touchoff-pump coronary revascularization. Eur J Cardiothorac Surg， 2007， 32 （5）：711-717.
10. Briguori C， Testa U， Riccioni R， et al. Correlations between prog-ression of coronary artery disease and circulating endothelial progen-itorcells. FASEB J， 2010 24 （6）：1981-1988.
11. Verhoeffb J， Siebes M， Meuwissen M， et al. Influence of percutaneous coronary intervention on coronary microvas-cular resistance index. Circulation， 2005， 111 （1）：76-82.
12. Collins P， Webb CM， Chong CF， et al. Radial artery versus saphenousvein patency randomized trial：five-year angiographic follow-up. Circulation， 2008， 117 （22）：2859-2864.
13. Possati G， Gaudino M， Prati F， et al. Long-term results of the radial artery used for myocardial revascularization. Circulation， 2003， 108 （11）：1350-1354.
14. Tatoulis J， Buxton BF， Fuller JA， et al. Long-term patency of 1108 radial arterial-coronary angiograms over 10 years. Ann Thorac Surg， 2009， 88 （1）：23-29.
15. Buxton BF， Raman JS， Ruengsakulrach P， et al. Radial artery patency and clinical outcomes：five-year interim results of a randomizedtrial. J Thorac Cardiovasc Surg， 2003， 125 （6）：1363-1371.
16. Achouh P， Boutekadjirt R， Toledano D， et al. Long-term （5-to 20-year） patency of the radial artery for coronary bypass grafting. J Thorac Cardiovasc Surg， 2010， 140 （1）：73-79.
17. 邓勇志，孙宗全. 桡动脉在冠状动脉旁路移植术中的应用. 中国胸心血管外科临床杂志， 2007， 14 （4）：297-302.
18. Loop F， Lytle BW， Cosgrove DM， et al. Sternal wound complications after isolated coronary bypass grafting：early and late mortality， morbidity， and cost of care. Ann Thorac Surg， 1990， 49 （2）：179-186.
19. Grossi EA， Esposito R， Harris LJ， et al. Sternal wound infections and use of internal mammary artery grafts. Ann Thorac Surg， 1991， 102 （3）：342-347.
20. Zacharias A， Habib RH. Factors predisposing to median sternotomy complications. Deep vs superficial infection.Chest， 1996， 110 （5）：1173-1178.
21. 杭钧彪，孔烨，周健，等. 全动脉化非体外循环下冠状动脉旁路移植66例分析. 南方医科大学学报， 2010， 30 （10）：2411-2412.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Perioperative Outcomes of Coronary Artery Bypass Grafting Using the Radial Artery

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