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Long-Term Radial Artery Grafts with Previous Midterm Proven Patency
Roberto Rocha E Silva1, Maxim Goncharov1, Fabiane Letícia de Freitas1
1Department of Cardiovascular Surgery, Instituto do Coração, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Introduction:
Left internal thoracic artery to left anterior descending artery (LITA-LADA) grafting has become a fundamental part of coronary artery bypass grafting (CABG). This grafting has led to an increased use of other arterial conduits, of which the radial artery (RA) is the most popular. Whether RA can have the same long-term patency as LITA is controversial. The objective of this study is to access the long-term clinical follow-up and, when available, the patency rate of RA grafts.
Methods:
Twenty-six patients from a previous study with critical stenosis in all target vessels underwent complete arterial CABG with LITA and RA grafts from 1996 to 2003. They all underwent midterm multidetector computed tomography after surgery with the association of at least one patent LITA and one patent RA graft.
Results:
Twelve patients (46%) are alive with no angina symptoms. Six patients underwent a second image exam 12 to 16 years (average of 14 years) after surgery, with a total of six LITA-LADA and 14 RA grafts with 100% patency rate. Clinical follow-up five to 23 years after surgery (average of 14 years) showed only one death 12 years after surgery related to coronary artery disease (CAD) (3,8%). Another 12 patients died of non-CAD.
Conclusion:
Patients with midterm associated LITA and RA patent grafts show similar optimal long-term patency rates of both types of grafts with excellent clinical outcome.
