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Ann Thorac Surg 2002;74:1144-1147
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Use of radial artery graft reduces the morbidity of coronary artery bypass graft surgery in patients aged 65 years and older

Thomas Modine, MDa, Sharif Al-Ruzzeh, FRCSa, Waseem Mazrani, MRCSa, Fazil Azeem, MRCSa, Mahmoud Bustami, MRCPa, Charles Ilsley, FRCPa, Mohamed Amrani, FETCS*a

a The National Heart and Lung Institute, Imperial College of Science, Technology, and Medicine, Harefield Hospital, Middlesex, United Kingdom

Accepted for publication May 29, 2002.

* Address reprint requests to Mr Amrani, Department of Cardiac Surgery, Harefield Hospital, Hill End Rd, Middlesex UB9 6JH, United Kingdom
e-mail: mr.amrani{at}rbh.nthames.nhs.uk

Background. The use of the radial artery graft in patients aged 65 years and older could prevent the occurrence of leg wound infection, which is known to increase the morbidity of coronary artery bypass grafting surgery.

Methods. We reviewed, retrospectively, 261 patients aged 65 years and older (age range 65 to 93 years), who underwent coronary artery bypass grafting surgery between February 1998 and August 2001. All the patients received at least one radial artery graft in addition to either a left internal thoracic artery, right internal thoracic artery, or saphenous vein graft as required. Saphenous vein grafts were used in 141 (54.1%) patients (group 1), and these were compared to 120 (45.9%) patients (group 2) who received only arterial conduits. Angiography was performed on 26 consecutive patients. The aim of the study was to review the clinical and angiographic outcomes in this population.

Results. The mean number of distal anastomoses performed was 2.98. Mean global operating time was 204 minutes. This time dropped to 201 minutes in group 1 versus 231 minutes in group 2; p = 0.009. Sixteen (11.3%) patients receiving saphenous vein grafts had leg wound infection whereas only 1 (0.3%) patient of the global population had a forearm infection. The mean global hospital stay was 9.81 days; this duration increased to 13 days when leg wound infection occurred versus 9.1 days when infection did not occur; p = 0.008. Twenty-six (10%) patients underwent an early angiographic study. Twenty-four (92.3%) radial artery grafts were patent.

Conclusions. The routine use of radial artery grafts in patients aged 65 years and older is feasible, safe, and does not increase mortality, morbidity, or the complexity of coronary artery bypass grafting surgery.




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