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Ann Thorac Surg 2002;73:143-148
© 2002 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Royal Melbourne and Epworth Hospitals, The University of Melbourne, Melbourne, Victoria, Australia
* Address reprint requests to Dr Tatoulis, Suite 28, Private Medical Centre, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
e-mail: james.tatoulis{at}mh.org.au
Presented at the Thirty-seventh Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 29–31, 2001.
Background. The radial artery (RA) has been used extensively by us as a way of reducing the use of the saphenous vein. It has been hoped that the RA will maintain greater late patency than the saphenous vein. We evaluated our initial 5-year experience with the RA in coronary surgery.
Methods. We studied 6,646 consecutive patients who had a single RA (4,872), or bilateral RA (1,774), as coronary grafts, from June 1995 to June 2000. Angiograms were performed mostly in symptomatic patients, or as part of a research project in asymptomatic patients.
Results. The patients’ mean age was 65.1 years; 23% had diabetes, 14% had unstable angina, and 42% had prior myocardial infarction. An average of 3.3 grafts per patient were performed, 87% from arterial conduit. Conduits used were RA (8,420), left internal thoracic artery (6,296), and right internal thoracic artery (1,076). Operative mortality occurred in 58 (0.9%) patients, stroke in 92 (1.4%), deep sternal infection in 97 (1.4%), reoperation for hemorrhage in 56 (0.9%), and myocardial infarction in 52 (0.8%). Peak mean postoperative creatine kinase MB (CKMB) was 16.5 IU/L. Two patients developed fingertip ischemia. Postoperative angiographic RA patency was 90.2% (333 of 369 distal anastomoses).
Conclusions. Good early clinical and angiographic results can be achieved by using the RA in coronary surgery.
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