Coronary artery bypass grafting using the radial artery: Midterm results in a Japanese institute

Background. To avoid remote cardiac events associated with graft occlusions , arterial conduits are being increasingly utilized in coronary artery bypa ss grafting (CABG). The development of antispasmic agents has enabled the u se of the radial artery as a graft conduit in CABG. Methods. Between December 1995 and December 1998, 920 consecutive isolated CABG operations were performed at Shin-Tokyo Hospital. The radial artery wa s used for graft conduits in 475 of these patients, and their data were ana lyzed in this study. The patients were followed to determine midterm graft patency, cardiac events, and survival. All data are given as mean +/- stand ard deviation. The end points were patient death or occurrence of cardiac e vents. Results. The radial artery was used in 475 patients (366 males and 109 fema les, with a mean age of 64.5 +/- 8.5 years). The left internal mammary arte ry was used in 94.9% of patients, the right internal mammary artery in 17.5 %, the gastroepiploic artery in 50.9%, the inferior epigastric artery in 0. 2%, and the saphenous vein in 39.2%. The in-hospital morbidity and mortalit y rates of the studied group were 12.8% and 0.6%, respectively. A major com plication related to radial artery harvesting, compartment syndrome of the arm due to postoperative bleeding, was observed in 1 patient. No postoperat ive myocardial infarction attributable to radial artery bypass was observed . During the late follow-up period of 3.5 +/- 0.9 years, cardiac events wer e observed in 63 patients, giving actuarial 2- and 3-year event-free rates of 92.8% and 89.6%, respectively. A total of 24 late deaths were noted, inc luding seven cardiac deaths, giving actuarial 2- and 8-year survival rates of 98.1% and 97.2%, respectively. Postoperative angiography was performed i n selected patients. The cumulative graft patency rate of the radial artery was 93.0% during the mean angiographical follow-up period of 1.5 +/- 1.1 y ears. Conclusions. No adverse effects were noted after CABG using a radial artery graft in this short- and midterm follow-up period. (C) 2001 by The Society of Thoracic Surgeons.