Impact of Radial Artery Graft Anastomosis Strategies on Flow Characteristics and Early Patency in Coronary Artery Bypass Grafting
10.3969/j.issn.1000-3614.2024.02.004
- VernacularTitle:桡动脉桥使用策略对冠状动脉旁路移植术中桥血流及早期通畅性的影响
- Author:
Zengqiang HAN
1
;
Guangpu FAN
;
Zhou ZHAO
;
Yi SHI
;
Yu CHEN
Author Information
1. 北京大学人民医院 心脏外科,北京 100044
- Keywords:
coronary artery bypass grafting;
radial artery;
transit time flow measurement
- From:
Chinese Circulation Journal
2024;39(2):127-132
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:The aim of this study was to assess the influence of graft anastomosis strategies of radial artery on the flow characteristics and early patency in coronary artery bypass grafting(CABG). Methods:Present study enrolled 99 patients(92 males,7 females,aged[57.2±8.7]years),who underwent isolated CABG using a radial artery(RA)graft from January 2019 to December 2021 in our department.The RA was proximally anastomosed to the aorta in 79 patients(group 1)and to another graft as a composite graft in 20 patients(group 2).The intraoperative flow characteristics were evaluated with the transit time flow measurement(TTFM),and the graft patency was assessed by computed tomography coronary angiograms perioperatively and at 1year after operation respectively. Results:Baseline characteristics were similar between the two groups(all P＞0.05).There was no perioperative death.Incidence of minimally invasive cardiac surgery for CABG(MICS CABG)and mean flow(MF)of RA grafts were both higher in group 2 than in group 1(all P＜0.05).Perioperative RA graft failure rate was 24.2%(n=24),which tended to be lower in group 2 than in group 1(10.0%vs.27.8%,P=0.096).CT angiography showed that RA graft failure reduced to 16.1%at one year after operation.Compared to patency group,patients with failure RA grafts perioperatively had higher pulse index(PI)and lower intraoperative MF(all P＜0.05).Patients with failure RA grafts at one year after operation had higher PI and more bypassed to the right coronary artery(RCA)target territories of RA grafts(all P＜0.05). Conclusions:RA proximal anastomosis to the aorta or to another graft dose not affect the perioperative patency in CABG.Some RA graft that failed perioperatively might recanalize at one year after operation.High intraoperative PI and bypassed to RCA of RA grafts may be predictors of graft failure at one year after operation.
