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J Thorac Cardiovasc Surg 1998;116:1015-1021
© 1998 Mosby, Inc.
SURGERY FOR ADULT CARDIOVASCULAR DISEASE |
From the Departments of Cardiac Surgerya and Cardiology,b Catholic University, and the Department of Cardiology, Campus Biomedico University,c Rome.
Received for publication May 20, 1998. Revisions requested July 20, 1998.Revisions received Aug 17, 1998. Accepted for publication Sept 8, 1998. Address for reprints: Gianfederico Possati, MD, Divisione di Cardiochirurgia, Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy.
Objective: To evaluate the midterm angiographic results of the use of radial artery grafts for myocardial revascularization.
Methods: The first 68 consecutive surviving patients who received a radial artery graft proximally anastomosed to the aorta at our institution were studied again at 5 years (mean 59 ± 6.5 months) of follow-up; 48 of these patients had previously undergone an early angiographic examination. The response of the radial artery to the endovascular infusion of serotonin was evaluated 1 and 5 years after the operation, and the midterm status of the radial artery graft was correlated with the degree of preoperative stenosis of the target vessel and with calcium-channel blocker therapy.
Results: The patency and perfect patency rates of the radial artery grafts 5 years after the operation were 91.9% and 87.0%, respectively. All radial artery grafts that were patent early after the operation remained patent at midterm follow-up, and early parietal irregularities in 7 patients were seen to have disappeared after 5 years. The early propensity toward graft spasm after serotonin challenge was markedly decreased at midterm follow-up. The continued use of calcium-channel antagonists after the first postoperative year did not influence the radial artery graft status, whereas the preoperative severity of the target-vessel stenosis markedly influenced the angiographic results.
Conclusions: The midterm angiographic results of radial artery grafts used for myocardial revascularization are excellent. The correct surgical indication is essential. Continued therapy with calcium-channel antagonists after the first year does not influence the midterm angiographic results.
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