Myocardial revascularization with radial and mammary arteries: Initial andmid-term results

Background. The radial artery is being used with increasing frequency inste ad of the saphenous vein in coronary artery bypass grafts. We analyzed the in hospital and midterm results in patients undergoing coronary artery bypa ss surgery in whom a combination of arterial grafts was used, including rad ial artery and one or both internal mammary arteries. Methods. Between 1995 and 1998, 1,023 patients underwent coronary artery by pass surgery using arterial conduits. The left internal mammary artery and the right internal mammary artery were employed in combination with the rad ial artery. Results. An average of 3.2 grafts per patient were done. The left internal mammary artery and radial artery were used in 100% of patients, the right i nternal mammary artery in 21.7%, and a venous graft in 31%. The operative m ortality rate was 2.5%. On repeat angiography performed in 62 patients befo re their discharge, the arterial conduits were patent in 98.4%. Mean follow -up was 25.0 +/- 9.6 months (1 to 48 months). The probability of survival w as 92.8% Conclusions. Revascularization using mammary and radial artery grafts is sa fe. Complications are not higher than those observed with saphenous vein gr afting. It was possible to use arterial conduits in all the patients, even in those with impaired left ventricular function. (C) 2000 by The Society o f Thoracic Surgeons.