Mid-Term Results of Radial and Mammary Arteries as the Conduits of Choice for Complete Arterial Revascularization in Elective and Nonelective Coronary Bypass Surgery

Chowdhry, Tayseer; Loubani, Mahmoud; Galiñanes, Manuel

doi:10.1111/j.1540-8191.2005.00155.x

Cited by 9 publications

(7 citation statements)

References 26 publications

(29 reference statements)

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“…The RA grafts showed excellent patency when used sequentially, consistent with the literature [8,[13][14][15][16]. The isolated grafts were present in small numbers and showed a decrease of patency in relation to the sequential grafts, but without statistical difference.…”

Section: Discussionsupporting

confidence: 87%

Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomas

Silva

Truffa

Birolli

et al. 2009

Rev Bras Cir Cardiovasc

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Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomasCABG late angiographic grafting patency analysis in patients with recurrent symptoms Abstract Objective: Left internal thoracic artery (LITA) grafting has become essential in coronary artery bypass graft procedure (CABG). In order to optimize the use of LITA or other grats, sequential anastomosis has been used. There is no consensus on equivalence between isolated versus sequential grafts. The aim of this study is to compare isolated versus sequential grafts.Methods: From a retrospective patency analysis of the grafts used in 88 symptomatic patients who underwent CABG procedure in our Service was performed through cinecoronariography. Statistical analysis was performed through Student's t test. Each distal anastomosis was considered an independent graft.Results: The mean postoperative period was of 53 + 138 months and mean age was 64 + 11 years. LITA isolated grafts presented patency rate significantly higher than the sequential grafts, respectively 92% (46/50) and 77% (30/39) P = 0.02. However, in injured coronary arteries of > 70%, isolated LITA patency rate was similar to sequential grafts, (95%; 37/39) and (93%; 26/28) respectively; P = 0.37. Mean radial artery patency rate was similar to isolated 71% (5/7) and sequential 90% (19/21) grafts; P = 0. Saphenous veinThis study was carried out at the Paulo Sacramento Hospital. patency rates were similar for isolated 72% (31/43) and sequential 81% (73/90) grafts; P = 0.12. There was no difference between radial artery and saphenous vein patency rates.Conclusion: In symptomatic patients, isolated LITA patency is superior than sequential LITA. However, in coronary injuries of > 70%, the isolated and sequential patency rates are similar. Sequential grafts from radial artery and saphenous vein are similar to their respective isolated grafts. Descriptors: Radial artery. Mammary arteries. Saphenous vein. Coronary disease/surgery. Myocardial revascularization. Resumo Objetivo: A Artéria Torácica Interna Esquerda (ATIE) é o padrão ouro como enxerto na revascularização miocárdica (RM). Para otimizar seu uso, e de outros enxertos, têm sido usadas anastomoses sequenciais. Não há consenso da equivalência dos resultados entre enxertos isolados e sequenciais. O objetivo é comparar a perviabilidade dos enxertos isolados versus sequenciais. 139ROCHA E SILVA, R ET AL -CABG late angiographic grafting patency analysis in patients with recurrent symptoms Bras Cir Cardiovasc 2009; 24(2): 138-142 Rev

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Section: Discussionsupporting

confidence: 87%

Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomas

Silva

Truffa

Birolli

et al. 2009

Rev Bras Cir Cardiovasc

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“…[17][18][19] Hayashi 20 described complete arterial revascularization in 9 emergency patients with a good outcome. In a similar study, Nishida 21 conducted a study with 37 patients and showed a 5 year survival rate of 97.1% and a patency rate of 100% for RA, 3 to 4 weeks after surgery.…”

Section: Introductionmentioning

confidence: 99%

Elective vs Non-Elective Radial Artery Grafts: Comparing Midterm Results Through 64-Slice Computed Tomography

Rocha-e-Silva

Santos

Rochite

et al. 2007

Clinics

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Elective vs non-elective radial artery grafts: comparing midterm results through 64-Slice Computed Tomography. Clinics. 2007; 62(6):725-30.BACKGROUND: Left internal thoracic artery to left anterior descending artery (LITA-LADA) grafting has become a fundamental part of the coronary artery bypass graft procedure (CABG). This grafting in turn has led to an increased use of other arterial conduits, of which the radial artery (RA) is most popular. Whether RA grafting can be used in the emergency patient is controversial. METHODS: 47 patients with critical stenosis (≥70%) in all target vessels underwent CABG with LITA and RA grafts from 1996 to 2003. Patients were divided into elective (23 patients) and non-elective groups (24 patients) with LITA and RA grafts per patient being similar in both groups. Of these 47 patients, 5 died from non-cardiac complications and 12 were unavailable. Thus, 30 patients (71% of survivors) were studied by multidetector computed tomography. A total of 36 LITA and 64 RA grafts were studied. RESULTS: The RA patency rate for elective and non-elective grafts were 82% (31/38) and 85% (22/26), respectively (p=0.75). The RA had a similar patency rate for all target vessels ranging from 73% to 100%. Only one patient had a redo CABG and 29 (97%) are free from angina or re-intervention. LITA-LADA had a 92% (11/12) and 100% (10/10) patency rate for elective and non-elective groups, respectively (p=0.37). The sequential LITA-diagonal-LADA in the elective group had a 50% (03/06) patency rate, which was significantly lower than the 100% (08/08) patency rate of the non-elective group (p=0.02). CONCLUSION: Radial Artery grafts can be used in both elective and non-elective patients with excellent results.

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“…where the bulk compression is 36.0 m 2 /s 2 and the absolute pressure ranges between the maximum absolute pressure of 2610 5 Pa and the minimum absolute pressure of 10 000 Pa. The fluid region is considered to be isothermal with a reference temperature of 32 uC and a specific heat capacity of 4200 J/kg k. Flow measurement with pulsed Doppler ultrasound acquired in the right internal carotid was used to obtain the physiological flow conditions before proximal anastomosis [43].…”

Section: Boundary Conditions and Physics Interfacementioning

confidence: 99%

“…The technique uses an autologous vein or prosthetic conduit inserted into the proximal and distal diseased segment of the artery in order to restore normal blood flows in myocardial infarction. However, a weak long-term patency rate has been reported because of the intimal hyperplasia (IH) problem and restenosis [5][6][7][8][9][10]. In-vivo and in-vitro studies by Glagov [11], Hofer et al [12] and Sottiurai et al [13] suggested that such abnormalities principally occur at the distal anastomosis of a bypass system at the heel or toe, along the suture line, and on the artery floor opposite to the junction.…”

Section: Introductionmentioning

confidence: 99%

Haemodynamic analysis of coronary artery bypass grafting in a non-linear deformable artery and Newtonian pulsatile blood flow

Kouhi

Morsi

Masood

2008

Proc Inst Mech Eng H

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A three-dimensional (3D) computational model of stenotic coronary artery bypass grafting (CABG) system with fluid-structure interaction (FSI) using realistic physiological conditions is introduced. Unsteady pulsatile blood flow is applied to the wall of non-linear deformable arteries over the systolic period. In the analysis, the arbitrarily Lagrangian-Eulerian (ALE) formulation is used to couple the fluid region and solid domain. The method couples the equations of the deformation of the artery wall and applies them as the fluid domain boundary condition. The flow distribution and haemodynamic forces are presented in terms of velocity profiles and temporal and spatial wall shear stresses (WSSs) at the distal area. Rapid changes in the flow fields are observed in the early stages of the cardiac cycle, which alters the location of the recirculation zone from the toe to the host bed and then to the heel. The migration of the recirculation zone, considering the effect of deformability of the artery wall, indicates the same trend as the rigid wall model according to the location of low and high WSSs. However, the WSSs in the critical areas such as toe, heel, and suture lines are found to have dramatic drops in magnitudes in comparison with those of the rigid wall model. This could initiate the promotion of intimal hyperplasia (IH) and may cause an early graft failure in CABG.

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Mid-Term Results of Radial and Mammary Arteries as the Conduits of Choice for Complete Arterial Revascularization in Elective and Nonelective Coronary Bypass Surgery

Abstract: Total arterial revascularization with the internal mammary and radial artery is associated with a low rate of perioperative complications and mortality and can be safely used in both elective and nonelective bypass graft surgery with excellent clinical results.

Cited by 9 publications

References 26 publications

Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomas

Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomas

Elective vs Non-Elective Radial Artery Grafts: Comparing Midterm Results Through 64-Slice Computed Tomography

Haemodynamic analysis of coronary artery bypass grafting in a non-linear deformable artery and Newtonian pulsatile blood flow

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