Application of left internal mammary artery and bilateral radial arteries in off-pump total arterial coronary artery bypass grafting
10.7507/1007-4848.202307049
- VernacularTitle:左侧胸廓内动脉联合双侧桡动脉在非体外循环全动脉冠状动脉旁路移植术中的应用
- Author:
Shengzhong LIU
1
;
Dachuang WEI
1
;
Bo XIANG
1
;
Jin TAN
1
;
Lu JIANG
1
;
Tao YU
1
;
Keli HUANG
1
Author Information
1. Department of Cardiovascular Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, P. R. China
- Publication Type:Journal Article
- Keywords:
Total arterial coronary artery bypass grafting;
left internal thoracic artery;
radial artery;
off-pump;
efficacy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(08):1159-1165
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of total arterial off-pump coronary artery bypass grafting (OPCABG) using a left internal thoracic artery (LITA) combined with bilateral radial arteries (RAs). Methods We retrospectively analyzed the clinical data of patients with severe multi-vessel coronary artery disease who underwent total arterial OPCABG with a LITA and bilateral RAs at Sichuan Provincial People’s Hospital from November 2020 to April 2023. Results A total of 24 patients were included, comprising 23 males and 1 female, with a mean age of (53.63±4.33) years. The New York Heart Association (NYHA) functional class was Ⅱ to Ⅲ. The mean number of distal anastomoses was 3.17±0.38. A Y-graft was constructed in 12 patients and sequential grafting was performed in 4 patients. Concomitant procedures included coronary endarterectomy in 1 patient, intra-aortic balloon pump (IABP) implantation in 10 patients, and thymoma resection in 1 patient. The mean operative time was (308.13±30.39) min, mechanical ventilation time was (15.42±7.42) h, ICU stay was (46.08±27.32) h, and postoperative hospital stay was (11.71±1.90) d. There were no in-hospital deaths. Postoperative complications included one patient of acute renal failure and one patient of cerebral infarction. Pre-discharge color Doppler echocardiography revealed that the left ventricular end-diastolic diameter was significantly smaller than before surgery (P<0.05), while the left ventricular ejection fraction and fractional shortening were significantly higher (P<0.05). Coronary computed tomography angiography (CTA) showed that all arterial grafts were patent. During a mean follow-up of (14.58±8.75) months, no patients experienced angina recurrence or mortality. Repeat coronary CTA or angiography in 16 patients one year postoperatively confirmed that all arterial grafts remained patent. Conclusion Total arterial OPCABG using a LITA and bilateral RAs is a safe and effective treatment for patients with severe multi-vessel coronary artery disease. For high-risk patients, intraoperative IABP support is recommended.
