Clinical Outcomes for Radial Artery Versus Saphenous Vein in Coronary Artery Bypass Graft Surgery

Abstract

Introduction:The long-term patency of conduits used is one of the most important variables in determining long-term outcomes aftercoronaryarterybypass grafting (CABG) 1 .It has been well documented and demonstrated that the use of the left internal mammary artery (LIMA) to graft the left anterior descending (LAD) artery is gold standard for conventional CABG operations and has signiûcant beneûts compared with using asaphenous vein graft (SVG) 1 .Its use has been shown to result in a lower incidence of re-intervention, fewer myocardial infarctions, a lower incidence of angina, and lower associated mortality rates than with the use of saphenous vein grafts alone 1 .It was assumed that this inherent superiority of the LIMA over SVG would also be true of other arterial conduits such as the right internal mammary artery (RIMA), the radial artery (RA) and the right gastroepiploic artery (RGEA). 1 This assumed inherent superiority of using any arterial conduit compared with using an SVG to targets other than the LAD artery has been much harder to prove. Conduit selection for the left circumflex and right coronary artery territories has been more variable amongst surgeons. 2 right ITA is less useful than the left ITA, as it will not always reach the right coronary artery (RCA) branches without tension, leading to its use predominantly as a free graft, with a lower patency rate when attached to the ascending aorta. Another reason for cautious use of bilateral ITA was related to the increased risk of sternal wound infection. Results: This study reports on our series of 200 patients undergoing isolated, primary CABG using LIMA grafting and the SVG in one group, and RA grafting as the second conduit in the second group. Our data indicate that there is no difference in the long-term clinical outcome between the patients in whom RA or SVG is used as a second conduit, beside LIMA. Conclusion:In this small randomized study our data indicate that there is no difference in the 4 year clinical outcomes in relatively young patients between those having a RA or a saphenous vein graft used as a second conduit, beside LIMA, for surgical myocardial revascularization.

Systematic Review and Pooled Meta-analysis of the Current Status of Coronary Revascularization Surgery in Bangladesh

“…al 20,24,33,35 and 2 studies each from Alam et. al 22,32 and Sazzad et. al, 18,27 all published in different years had been included in our meta-analysis as seen in Table 1.…”