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Comparison of Radial Artery and Saphenous Vein Composite Y Grafts during Off-pump Coronary Artery Bypass.

Wi JH, Joo HC, Youn YN, Song SW, Kim TH, Yoo KJ - Korean J Thorac Cardiovasc Surg (2013)

Bottom Line: The safety and efficacy of arterial composite grafts for total arterial revascularization have been demonstrated.After propensity score matching, 79 radial arterial (RA) composite grafts (RA group) and 79 saphenous vein composite grafts (SV group) were compared.Construction of composite Y-grafts using the radial artery or saphenous vein showed similar mid-term results.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea.

ABSTRACT

Background: The safety and efficacy of arterial composite grafts for total arterial revascularization have been demonstrated. The saphenous vein (SV) is a widely used graft because of its accessibility, sufficient length, and ease of manipulation. Our aim was to compare mid-term outcomes of saphenous vein Y-grafts with radial artery Y-grafts joined by anastomosis to the left internal thoracic artery.

Materials and methods: Records of off-pump coronary artery bypass grafting with composite Y-grafts based on the left internal thoracic artery technique in 552 patients were analyzed retrospectively. After propensity score matching, 79 radial arterial (RA) composite grafts (RA group) and 79 saphenous vein composite grafts (SV group) were compared. The duration of mean follow-up was 24.6±14.6 months (range, 1 to 55 months).

Results: There were no differences in surgical mortality, all-cause mortality, or morbidity among the groups. Rates of 4-year survival were 91.7% and 96.3% in the RA and SV groups, respectively (p=0.519). The coronary reintervention-free survival rate and freedom from major adverse cardiovascular or cerebrovascular events were similar in the two groups (p=0.685, p=0.564).

Conclusion: Construction of composite Y-grafts using the radial artery or saphenous vein showed similar mid-term results. Long-term follow-up and randomized trials will be needed to confirm our present conclusions.

No MeSH data available.


Related in: MedlinePlus

Overall survival rate comparing radial artery (RA) group and saphenous vein (SV) group in (A) entire study groups (B) matched groups.
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Figure 1: Overall survival rate comparing radial artery (RA) group and saphenous vein (SV) group in (A) entire study groups (B) matched groups.

Mentions: The surgical mortality was 1.27% (1/79) in the RA group, and this value was not significantly different than 0% in the SV group. There were no significant differences in the incidence of postoperative morbidities, such as MACCEs, stroke, myocardial infarction, coronary reintervention, mediastinitis, atrial fibrillation, low cardiac output syndrome, wound problems, respiratory complications, peripheral vascular complications, or acute renal failure (Table 3). Two late mortalities occurred, one in the RA group (cancer-related death) and the other in the SV group (sudden death of unknown origin). The 4-year survival rates were 91.7% and 96.3% in the RA and SV groups, respectively (p=0.519) (Fig. 1). Three patients underwent coronary reintervention during follow-up. Coronary reintervention-free survival rates at 4 years were 94.4% and 98.7% in the RA and SV groups, respectively (p=0.685) (Fig. 2). Freedom from MACCEs at 4 years was also similar in the two groups (p=0.564) (Fig. 3).


Comparison of Radial Artery and Saphenous Vein Composite Y Grafts during Off-pump Coronary Artery Bypass.

Wi JH, Joo HC, Youn YN, Song SW, Kim TH, Yoo KJ - Korean J Thorac Cardiovasc Surg (2013)

Overall survival rate comparing radial artery (RA) group and saphenous vein (SV) group in (A) entire study groups (B) matched groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756157&req=5

Figure 1: Overall survival rate comparing radial artery (RA) group and saphenous vein (SV) group in (A) entire study groups (B) matched groups.
Mentions: The surgical mortality was 1.27% (1/79) in the RA group, and this value was not significantly different than 0% in the SV group. There were no significant differences in the incidence of postoperative morbidities, such as MACCEs, stroke, myocardial infarction, coronary reintervention, mediastinitis, atrial fibrillation, low cardiac output syndrome, wound problems, respiratory complications, peripheral vascular complications, or acute renal failure (Table 3). Two late mortalities occurred, one in the RA group (cancer-related death) and the other in the SV group (sudden death of unknown origin). The 4-year survival rates were 91.7% and 96.3% in the RA and SV groups, respectively (p=0.519) (Fig. 1). Three patients underwent coronary reintervention during follow-up. Coronary reintervention-free survival rates at 4 years were 94.4% and 98.7% in the RA and SV groups, respectively (p=0.685) (Fig. 2). Freedom from MACCEs at 4 years was also similar in the two groups (p=0.564) (Fig. 3).

Bottom Line: The safety and efficacy of arterial composite grafts for total arterial revascularization have been demonstrated.After propensity score matching, 79 radial arterial (RA) composite grafts (RA group) and 79 saphenous vein composite grafts (SV group) were compared.Construction of composite Y-grafts using the radial artery or saphenous vein showed similar mid-term results.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea.

ABSTRACT

Background: The safety and efficacy of arterial composite grafts for total arterial revascularization have been demonstrated. The saphenous vein (SV) is a widely used graft because of its accessibility, sufficient length, and ease of manipulation. Our aim was to compare mid-term outcomes of saphenous vein Y-grafts with radial artery Y-grafts joined by anastomosis to the left internal thoracic artery.

Materials and methods: Records of off-pump coronary artery bypass grafting with composite Y-grafts based on the left internal thoracic artery technique in 552 patients were analyzed retrospectively. After propensity score matching, 79 radial arterial (RA) composite grafts (RA group) and 79 saphenous vein composite grafts (SV group) were compared. The duration of mean follow-up was 24.6±14.6 months (range, 1 to 55 months).

Results: There were no differences in surgical mortality, all-cause mortality, or morbidity among the groups. Rates of 4-year survival were 91.7% and 96.3% in the RA and SV groups, respectively (p=0.519). The coronary reintervention-free survival rate and freedom from major adverse cardiovascular or cerebrovascular events were similar in the two groups (p=0.685, p=0.564).

Conclusion: Construction of composite Y-grafts using the radial artery or saphenous vein showed similar mid-term results. Long-term follow-up and randomized trials will be needed to confirm our present conclusions.

No MeSH data available.


Related in: MedlinePlus