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Assessing the Safety of Sequential Radial Artery Grafting in Coronary Revascularization
AlleaBelle Bradshaw1, Ifeanyi Chinedozi1, Jace C Bradshaw2
1Division of Cardiac Surgery, Department of Surgery, Johns Hopkins, Baltimore, Maryland.
Background:
Use of the radial artery (RA) as a conduit during coronary artery bypass grafting is associated with better outcomes compared with vein. However, data on the RA as a sequential graft are limited. This study assessed the safety and efficiency of using sequential RA grafting.
Methods:
Patients with sequential vs nonsequential RA grafting by 1 surgeon from 2 hospitals from 2001 to 2022 were compared using propensity matching. Primary outcomes were total artery revascularization (TAR) and incomplete revascularization. Secondary outcomes included cardiopulmonary bypass and cross-clamp times, total number of arterial grafts, 30-day mortality, and complications. The Mann-Whitney U test, χ2 test, and propensity matching were used.
Results:
Of 517 patients who received RA grafting, 107 (20.7%) were sequential. After matching, there were 107 patients in the sequential group and 321 in the nonsequential group. Sequential RA use was associated with more TAR (P < .001) and less incomplete revascularization (P = .002). Matched patients with sequential RA grafting and 4 grafts had shorter bypass and cross-clamp times (P < .001). No differences were observed in clinical outcomes between matched groups.
Conclusions:
Patients with sequential RA grafting had more TAR with equivalent outcomes compared with those with single RA. These findings support the safety and efficiency of sequential RA grafting.
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