EVOLUTION OF COMPLETE ARTERIAL GRAFTING FOR CORONARY-ARTERY DISEASE

Arterial grafting for the correction of coronary artery disease preced ed the use of saphenous vein grafts, but the overwhelming popularity o f the saphenous vein from 1970 To 1985 left the development of arteria l grafting dormant. Excellent graft patency results from pedicled inte rnal thoracic artery grafting and continued saphenous vein graft failu re prompted our unit to explore complete arterial grafting with intern al thoracic artery and radial artery grafts. One thousand and fifty-th ree patients who received a combination of internal thoracic artery an d radial artery grafts were compared with 1,156 patients who received internal thoracic artery and saphenous vein grafts. Aii patients under went primary coronary artery bypass surgery between 1995 and 1998. The early mortality and morbidity and the probability of survival at 2 ye ars were similar in both groups of patients. Early graft patency studi es of 35 radial artery grafts showed 33 (94%) were patent at a mean of 12 months. Complete arterial grafting using internal thoracic and rad ial arteries is safe and may provide a long-term benefit.