Myocardial revascularization with multiple arterial grafts: Comparison between the radial artery and the right internal thoracic artery

Background. Bilateral internal thoracic artery (ITA) harvesting is signific antly underused, whereas the radial artery is being used with increasing fr equency. We have retrospectively analyzed perioperative and short-term outc omes of patients receiving a radial artery versus those receiving a right I TA as a second arterial graft. Methods. Between February 1999 and May 2000, 250 patients underwent coronar y artery bypass grafting using the radial artery (156 patients) or the righ t ITA (94 patients) in combination with the left ITA and, when required, th e saphenous vein. Results. There was a higher prevalence of risk factors in the radial artery group. More coronary artery bypass graftings (p < 0.001) were performed wi th the radial artery. Operative mortality was not different (p = not signif icant). In the right ITA group there was more bleeding (p < 0.001) and a lo nger hospital stay (p < 0.001). Mean follow-up was 8.1 <plus/minus> 3.9 mon ths. The probability of survival was similar (p = not significant). Conclusions. The radial artery can extend the benefits of multiple arterial grafting to those patients who are usually excluded from bilateral ITA har vesting because of multiple risk factors. Perioperative and short-term resu lts are good. (C) 2001 by The Society of Thoracic Surgeons.