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Myocardial revascularization using the radial artery : Midterm results

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Cardiothoracic Surgery

Advisors

Gumaa, Magdi, El-Buraei, Wagih, Farouq, Tamer

Authors

Abdel-Azhim, Anas

Accessioned

2017-07-12 06:42:41

Available

2017-07-12 06:42:41

type

M.D. Thesis

Abstract

Background. The high incidence of late obstruction of venous bypass graft combined with the proven advantage of arterial revascularization stimulated a search for alternative conduit for CABG. The use of radial artery (RA), condemned as a bypass graft more than 20 years ago, has been revived with encouraging early and midterm results. Patients&Methods. Between January 2004 and March 2005, 50 patients with coronary artery disease underwent surgical myocardial revascularization using the RA as one of the bypass conduits. The patients consisted of 40 males (80%) and 10 females (20%) with an average age of 52.5 years (range 40-65 years). To prevent RA spasm, all patients received calcium channel blockers both intra-operatively and postoperatively. The RA was harvested in a pedicle including its satellite veins. Target vessels for RA grafting were: obtuse marginal branches (51.4%), diagonal branches (20%), PDA (18.5%). Patients were followed-up during their hospital stay as well as for a minimum of 2 years thereafter. All RA grafts were used as composite grafts with the LIMA. Results: 157 distal anastomoses were constructed (3.14 anastomosis/patient), 70 of these (44.5%) were done using RA grafts. In 36% of patients, RA was used sequentially. Only one of the study patient died (2%) early after surgery, 1 patient (2%) developed early postoperative MI and 2 patients (4%) showed evidence of postoperative ischaemia, but none in an area revascularized by a RA graft. Temporary parasthesia developed in 18 patients (36%) with no incidence of ischaemic or functional complications in the hand. Patient survival was 95% at 2.6 years. Symptom-directed coronary imaging was available for 14.3%. RA angiographic patency was 100% with none of the radial artery evaluated showing significant narrowing. Conclusion: the radial artery has several advantages over other conduits. It can be used safely to achieve total arterial revascularization or in cases of unavailable other conduits with encouraging early and Midterm results. Its use does not appear to increase complexity and morbidity associated with CABG.

Issued

1 Jan 2011

DOI

http://dx.doi.org/10.21473/iknito-space/38270

Details

Type

Thesis

Created At

31 Jan 2023