Should radial arteries be used routinely for coronary artery bypass grafting?

نویسندگان

  • Subodh Verma
  • Paul E Szmitko
  • Richard D Weisel
  • Daniel Bonneau
  • David Latter
  • Lee Errett
  • Yves LeClerc
  • Stephen E Fremes
چکیده

Case Presentation: Mr P is a 57-year-old construction worker who has had Canadian Cardiovascular Society class III angina for the past 3 months. He has multiple cardiovascular risk factors including smoking, hypertension, dyslipidemia, and diabetes. He is obese and has had a previous laparotomy for a perforated bowel. Coronary angiography revealed triple vessel disease involving the left anterior descending artery (LAD), the first obtuse marginal branch, and the right coronary artery (RCA), and an akinetic inferior wall with an estimated ejection fraction of 40%. The patient was referred for consideration of coronary artery bypass graft (CABG) surgery. Is Mr P a candidate for CABG and, if so, which vascular conduits should be used? CABG is the standard surgical procedure for the treatment of advanced coronary artery disease. Since the first successful results reported by Favaloro,1 CABG surgery has been demonstrated to improve symptoms and, in specific subgroups of patients, to prolong life.2 Despite its success, the long-term outcome of coronary bypass surgery is strongly influenced by the fate of the vascular conduits used. Five to 7 years after surgery, patients are at increased risk of suffering from ischemic complications coincident with graft failure.2 Furthermore, as patients undergoing CABG surgery become older with more preoperative risk factors, and treated patients are living longer and therefore requiring reoperation, the optimal selection of vascular grafts for bypass is essential.

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BACKGROUND The radial artery is often used as the second arterial graft for coronary artery bypass grafting. Little is known about the differences in long-term patency between radial free and T grafts. This study was performed to determine long-term radial artery patency over a 15-year period. METHODS AND RESULTS Radial arteries were used as free grafts or T grafts for coronary artery bypass ...

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عنوان ژورنال:
  • Circulation

دوره 110 5  شماره 

صفحات  -

تاریخ انتشار 2004