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Radial artery and inferior epigastric artery in composite grafts: improved midterm angiographic results.
Ann Thorac Surg. 1995 Sep; 60(3):517-23; discussion 523-4.AT

Abstract

BACKGROUND

The improving results with use of the radial artery and the inferior epigastric artery as coronary bypass conduits were analyzed to assess the suitability of these arteries for myocardial revascularization.

METHODS

Both arteries were used in composite arterial conduits with an internal mammary artery as the blood source. The proximal anastomosis was always constructed before the initiation of cardiopulmonary bypass. From October 1991 to January 1995, 240 patients underwent myocardial revascularization using 163 radial arteries and 124 inferior epigastric arteries with one (224 instances) or both (two instances) internal mammary arteries as inflow conduits. Twenty-five saphenous veins were concomitantly used. There were 208 men and 32 women with a mean age of 60.8 +/- 8.6 years (range, 28 to 80 years). In 73 patients (30.4%), the operation was performed on an urgent basis, and in 11 (4.6%), it was a repeat operation. The mean left ventricular ejection fraction was 0.55 +/- 0.12, and in 21 patients (8.8%), it was less than 0.35. Of 681 distal anastomoses, 188 were constructed using the radial artery (35 double and one triple sequential anastomosis) and 125, using the inferior epigastric artery (one double sequential anastomosis). A mean of 3.0 arterial anastomoses per patient were constructed (3.1 anastomoses/patient including saphenous veins). Six patients (2.5%) underwent associated procedures: aortic valve replacement (2), carotid endarterectomy (2), mitral valve replacement (1), and aortic valve and ascending aorta replacement (1). Most of the inferior epigastric arteries were grafted on diagonal branches and most of the radial arteries, the circumflex territory.

RESULTS

No deaths occurred in the operating room. Three patients (1.3%) died postoperatively, and 2 patients (0.8%) died 6 months after operation. At a mean follow-up of 18.5 +/- 10.4 months (range, 1 to 39 months), 227 patients (96.6%) were asymptomatic. The cumulative patency rate of the radial artery grafts was 93.1% and of the inferior epigastric artery grafts, 95.7%.

CONCLUSIONS

Our data suggest that use of the RA and the IEA in composite conduits for myocardial revascularization is feasible. These arteries can be safely used when bilateral internal mammary artery or sequential internal mammary artery grafting is not advisable.

Authors+Show Affiliations

Cattedra di Cardiochirurgia, Università di Chieti, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7677474

Citation

Calafiore, A M., et al. "Radial Artery and Inferior Epigastric Artery in Composite Grafts: Improved Midterm Angiographic Results." The Annals of Thoracic Surgery, vol. 60, no. 3, 1995, pp. 517-23; discussion 523-4.
Calafiore AM, Di Giammarco G, Teodori G, et al. Radial artery and inferior epigastric artery in composite grafts: improved midterm angiographic results. Ann Thorac Surg. 1995;60(3):517-23; discussion 523-4.
Calafiore, A. M., Di Giammarco, G., Teodori, G., D'Annunzio, E., Vitolla, G., Fino, C., & Maddestra, N. (1995). Radial artery and inferior epigastric artery in composite grafts: improved midterm angiographic results. The Annals of Thoracic Surgery, 60(3), 517-23; discussion 523-4.
Calafiore AM, et al. Radial Artery and Inferior Epigastric Artery in Composite Grafts: Improved Midterm Angiographic Results. Ann Thorac Surg. 1995;60(3):517-23; discussion 523-4. PubMed PMID: 7677474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radial artery and inferior epigastric artery in composite grafts: improved midterm angiographic results. AU - Calafiore,A M, AU - Di Giammarco,G, AU - Teodori,G, AU - D'Annunzio,E, AU - Vitolla,G, AU - Fino,C, AU - Maddestra,N, PY - 1995/9/1/pubmed PY - 1995/9/1/medline PY - 1995/9/1/entrez SP - 517-23; discussion 523-4 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 60 IS - 3 N2 - BACKGROUND: The improving results with use of the radial artery and the inferior epigastric artery as coronary bypass conduits were analyzed to assess the suitability of these arteries for myocardial revascularization. METHODS: Both arteries were used in composite arterial conduits with an internal mammary artery as the blood source. The proximal anastomosis was always constructed before the initiation of cardiopulmonary bypass. From October 1991 to January 1995, 240 patients underwent myocardial revascularization using 163 radial arteries and 124 inferior epigastric arteries with one (224 instances) or both (two instances) internal mammary arteries as inflow conduits. Twenty-five saphenous veins were concomitantly used. There were 208 men and 32 women with a mean age of 60.8 +/- 8.6 years (range, 28 to 80 years). In 73 patients (30.4%), the operation was performed on an urgent basis, and in 11 (4.6%), it was a repeat operation. The mean left ventricular ejection fraction was 0.55 +/- 0.12, and in 21 patients (8.8%), it was less than 0.35. Of 681 distal anastomoses, 188 were constructed using the radial artery (35 double and one triple sequential anastomosis) and 125, using the inferior epigastric artery (one double sequential anastomosis). A mean of 3.0 arterial anastomoses per patient were constructed (3.1 anastomoses/patient including saphenous veins). Six patients (2.5%) underwent associated procedures: aortic valve replacement (2), carotid endarterectomy (2), mitral valve replacement (1), and aortic valve and ascending aorta replacement (1). Most of the inferior epigastric arteries were grafted on diagonal branches and most of the radial arteries, the circumflex territory. RESULTS: No deaths occurred in the operating room. Three patients (1.3%) died postoperatively, and 2 patients (0.8%) died 6 months after operation. At a mean follow-up of 18.5 +/- 10.4 months (range, 1 to 39 months), 227 patients (96.6%) were asymptomatic. The cumulative patency rate of the radial artery grafts was 93.1% and of the inferior epigastric artery grafts, 95.7%. CONCLUSIONS: Our data suggest that use of the RA and the IEA in composite conduits for myocardial revascularization is feasible. These arteries can be safely used when bilateral internal mammary artery or sequential internal mammary artery grafting is not advisable. SN - 0003-4975 UR - https://www.unboundmedicine.com/medline/citation/7677474/Radial_artery_and_inferior_epigastric_artery_in_composite_grafts:_improved_midterm_angiographic_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0003-4975(95)00479-5 DB - PRIME DP - Unbound Medicine ER -