Comparison of the right internal thoracic artery and radial artery as a second arterial conduit in ‘Y’ composite fashion in patients undergoing coronary artery bypass grafting using total arterial revascularization

Introduction: The use of two arterial conduits for CABG is rapidly increasing. The second arterial conduit to LITA is usually RITA or radial artery. We sought to compare outcomes when either RITA or radial artery is exclusively used as a Y composite graft to LITA for total arterial revascularization. Material and methods:  We retrospectively analyzed 231 patients who underwent CABG in the period from 2010 to 2014. RITA was used in 178 patients (RITA group) and radial artery was used in 53 patients (radial group). Results: Radial was used more frequently in female patients and in diabetic patients. Radial group had comparable number of distal anastomoses and lesser operative time to RTIA group. Early postoperative outcomes (low cardiac output syndrome, post-operative myocardial infarction, use of intra-aortic balloon pump, post-operative stroke, re-explorations, incidence of deep sternal wound infection and death) were all comparable in both the groups. Late deaths and need for repeat revascularization were also similar in both the groups for up to 4 years after surgery. Only the incidence of major acute cardiac and cerebrovascular events (MACCE) was more in the radial group. Conclusion: Radial artery has comparable short- and mid-term outcomes to RITA when used as a second arterial conduit in CABG. Its use should be especially considered in diabetic patients when DSWI is a concern.