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Optimal target vessel selection for composite and sequential radial artery grafting with an in situ internal thoracic artery.
- Source :
-
Journal of Cardiac Surgery . Oct2017, Vol. 32 Issue 10, p613-620. 8p. - Publication Year :
- 2017
-
Abstract
- <bold>Objectives: </bold>We retrospectively evaluated graft patency in patients who underwent no-touch aortic arterial off-pump coronary artery bypass grafting to determine the optimal selection of target vessels for improved graft patency of composite and sequential radial artery I-grafts.<bold>Methods: </bold>The radial artery was anastomosed to the end of an in situ internal thoracic artery and was sequentially anastomosed to non-left anterior descending arteries. This composite graft was defined as an "I-graft." We evaluated 145 I-grafts with 2, 3, or 4 sequential anastomoses (437 graft segments). A graft segment with the final distal anastomosis of every I-graft was defined as the last graft segment (LGS). When a sequential anastomosis was initiated from the left coronary branch, the I-graft assumed a clockwise course (69.0%). When a sequential anastomosis was initiated from the right coronary branch, the I-graft assumed a counterclockwise course (31.0%).<bold>Results: </bold>On multivariable analysis, right coronary branch (P < 0.001), moderately stenotic (50-75%) target vessel (P = 0.004), and LGS with moderately stenotic target vessel (P = 0.005) were predictors of mid-term graft occlusion. In situations where the LGS was anastomosed to a severely stenotic target vessel (>75%) with a clockwise course, when the number of moderately stenotic target vessels among sequential graft segments was 0, 1, or ≥2, the mid-term graft patency rates of I-grafts were 94.0%, 86.0%, and 81.4%, respectively.<bold>Conclusions: </bold>The selection of target vessels for severely stenotic lesions among sequential graft segments and the clockwise course enhance the mid-term graft patency of sequential radial I-grafts. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08860440
- Volume :
- 32
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiac Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 125929546
- Full Text :
- https://doi.org/10.1111/jocs.13210