Coronary artery bypass grafting using the radial artery: influence of proximal anastomosis site in mid-term and long-term graft patency.

OBJECTIVE To determine whether the proximal anastomosis interferes or not in mid- and long-term patency of these grafts. METHODS One hundred twenty-three out of 481 patients who had undergone surgery using radial artery (RA) were restudied. The mean age was 58.8 + 10.4 years. In 96 (78.05%) patients the cardiopulmonary bypass (CPB) was used. Considering all surgical grafts, 382 coronary branches were grafted (mean, 3.1 + 0.8 arteries per patient). 150 of them used radial artery (RA), and the left marginal branches (LOM) were the most prevalent (48.67%). The proximal anastomosis was performed in the aorta in 50 (40.65%) patients and as an artificial 'Y' composite graft with the left or right internal thoracic artery (LIMA/RITA) in 73 (59.35%). Postoperatively, coronary angiography studies were performed within a mean period of 5.36 + 3.21 years. The obtained data was divided into two categories: proximal anastomosis (aorta/composite) and patency (occluded/patent). A chi-square test was used to compare both proportions, within a 95% confidence interval (CI). RESULTS From the 50 aorta-anastomosed grafts, 42 (84%) were patent and eight (16%) occluded. Regarding the 73 'Y' composite grafts, 59 (80.82%) were patent and 14 (19.18%) occluded. Comparing these proportions in both techniques, there was no statistically significant difference between them (P=0.651, CI=95%). CONCLUSION The site of proximal anastomosis of the RA coronary grafts does not interfere in mid- and long-term graft occlusion and patency.