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 |
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Korean Society for Thoracic & Cardiovascular Surgery
2021-04-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1818932827749613568 |
|---|---|
| author | Seung Keun Yoon Hyun Song Ju Yong Lim |
| author_facet | Seung Keun Yoon Hyun Song Ju Yong Lim |
| author_sort | Seung Keun Yoon |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-20T04:38:41Z |
| format | Article |
| id | doaj.art-7740ac1317384169942acc3b6f374bba |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-12-20T04:38:41Z |
| publishDate | 2021-04-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-7740ac1317384169942acc3b6f374bba2022-12-21T19:53:11ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142021-04-0154211712610.5090/jcs.20.082Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass GraftingSeung Keun Yoon0Hyun Song1Ju Yong Lim2The Catholic University of KoreaThe Catholic University of KoreaThe Catholic University of KoreaBackground: 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.coronary artery bypass graftingradial arteryvascular patencyvascular graft occlusionsurgical anastomosis |
| spellingShingle | Seung Keun Yoon Hyun Song Ju Yong Lim Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting Journal of Chest Surgery coronary artery bypass grafting radial artery vascular patency vascular graft occlusion surgical anastomosis |
| title | Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting |
| title_full | Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting |
| title_fullStr | Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting |
| title_full_unstemmed | Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting |
| title_short | Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting |
| title_sort | effect of the proximal anastomosis configuration of the radial artery in patients undergoing coronary artery bypass grafting |
| topic | coronary artery bypass grafting radial artery vascular patency vascular graft occlusion surgical anastomosis |
| work_keys_str_mv | AT seungkeunyoon effectoftheproximalanastomosisconfigurationoftheradialarteryinpatientsundergoingcoronaryarterybypassgrafting AT hyunsong effectoftheproximalanastomosisconfigurationoftheradialarteryinpatientsundergoingcoronaryarterybypassgrafting AT juyonglim effectoftheproximalanastomosisconfigurationoftheradialarteryinpatientsundergoingcoronaryarterybypassgrafting |