Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting
Background: Several factors, such as the degree of target vessel stenosis, are known to be associated with radial artery (RA) graft patency in coronary artery bypass grafting (CABG). There is a lack of data regarding the effect of the RA proximal configuration (aortic anastomosis versus T-anastom...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2021-04-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| Summary: | Background: Several factors, such as the degree of target vessel stenosis, are known
to be associated with radial artery (RA) graft patency in coronary artery bypass grafting
(CABG). There is a lack of data regarding the effect of the RA proximal configuration (aortic
anastomosis versus T-anastomosis). This study evaluated the effects of the RA proximal
configuration on the patency rate and clinical outcomes after CABG.
Methods: We conducted a retrospective study, analyzing 328 patients who had undergone
CABG with an RA graft. We divided the patients into 2 groups. The primary endpoint
was RA patency and the secondary endpoints were overall mortality and major adverse
cardiac and cerebrovascular events (MACCE). We performed a propensity score-matched
comparison.
Results: Aorta-RA anastomosis was performed in 275 patients, whereas the rest of the
53 patients received T-RA anastomosis. The mean age was 67.3±8.7 years in the T-RA anastomosis
group and 63.8±9.5 years in the aorta-RA anastomosis group (p=0.02). The mean
follow-up duration was 5.13±3.07 years. Target vessel stenosis ≥70% (hazard ratio [HR],
0.42; 95% confidence interval [CI], 0.20–0.91; p=0.03) and T-RA anastomosis configuration
(HR, 2.34; 95% CI, 1.01–5.19; p=0.04) were significantly associated with RA occlusion in the
multivariable analysis. However, T-RA anastomosis was not associated with higher risks of
overall mortality and MACCE following CABG (p=0.30 and p=0.07 in the matched group,
respectively).
Conclusion: Aorta-RA anastomosis showed a superior patency rate compared to T-RA
anastomosis. However, the RA proximal anastomosis configuration was not associated
with mortality or MACCE. |
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| ISSN: | 2765-1606 2765-1614 |