Coronary Artery Bypass Graft Surgery Using the Radial Artery, Right Internal Thoracic Artery, or Saphenous Vein as the Second Conduit. Academic Article uri icon

Overview

abstract

  • BACKGROUND: It is not clear whether radial artery (RA), right internal thoracic artery (RITA), or saphenous vein (SV) is the preferred second bypass graft during coronary artery bypass graft surgery using the left internal thoracic artery (LITA) in patients aged less or greater than 70 years. METHODS: Late survival data were collected for 13,324 consecutive, isolated, primary coronary artery bypass graft surgery patients from three hospitals. Cox regression analysis was performed on all patients grouped by age. RESULTS: Adjusted Cox regression showed overall better RA versus SV survival (hazard ratio [HR] 0.82, p < 0.001) and no difference in RITA versus SV survival (HR 0.95, p = 0.35). However, the survival benefit of RA versus SV was seen only in patients aged less than 70 years (HR 0.77, p < 0.001); and RITA patients aged less than 70 years also had a survival benefit compared with SV (HR 0.86, p = 0.03). There was no difference in survival for RA versus RITA across all ages. CONCLUSIONS: For patients aged less than 70 years, the optimal grafting strategy is using either RA or RITA as the second preferred graft. In patients aged 70 years or more, RA and RITA grafting should be used selectively. Multiple arterial grafting using either RA or RITA should be more widely utilized during coronary artery bypass graft surgery for patients less than 70 years of age.

publication date

  • February 16, 2017

Research

keywords

  • Coronary Artery Bypass
  • Coronary Artery Disease
  • Forecasting
  • Mammary Arteries
  • Radial Artery
  • Saphenous Vein

Identity

Scopus Document Identifier

  • 85012889065

Digital Object Identifier (DOI)

  • 10.1016/j.athoracsur.2016.11.017

PubMed ID

  • 28215422

Additional Document Info

volume

  • 104

issue

  • 2