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Ann Thorac Surg 2001;72:1552-1556
© 2001 The Society of Thoracic Surgeons
a Department of Cardiovascular Diseases, Catholic University School of Medicine, Santiago, Chile
b Clinica Alemana, Santiago, Chile
Accepted for publication June 28, 2001.
* Address reprint requests to Dr Moran, Department of Cardiovascular Diseases, Catholic University School of Medicine, Marcoleta 367, Santiago, Chile
e-mail: smoran{at}med.puc.cl
Background. Few data exist regarding angiographic predictors of radial artery patency for coronary bypass grafting, and the benefit of calcium antagonists is not clear.
Methods. One hundred fifteen patients were studied who had myocardial revascularization with the radial artery plus internal mammary and vein grafts with 3.5 ± 1.1 grafts per patient. Sixty-three patients received diltiazem and 52 patients did not. Base line and follow-up angiographies were analyzed 1 year postoperatively in 50 of these patients with a quantitative computerized method.
Results. One hundred fourteen patients survived and were followed for 30.1 ± 12.6 months. Patency for mammary grafts was 100%, for radial grafts it was 80%, and for saphenous vein grafts it was 68%. Patent radial artery grafts had significantly greater degree of stenosis in the native vessels than occluded grafts (73% ± 14% vs 40% ± 24%), (p = 0.0007; confidence interval = 95%). Radial artery patency increased to 92% when arteries with 70% or more stenosis were considered. No differences were observed for clinical and angiographic end points in the patients that received diltiazem compared with the rest who had not.
Conclusions. The degree of stenosis in the native coronary artery significantly influences the patency rate of radial artery grafts, independent of diltiazem.
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