Hung Dung VAN,MS MD- The Heart Institute Ho chi Minh City, Viet Nam Background : Until now, arterial grafts are better than veinous graft in longterm follow-up. What is the second choice or arterial graft beside the LIMA ? The RIMA, the radial artery, the gastroepiploic artery or the epigastric artery are always still debate in many articles.
Methods : prospective and cohort study in 65 conseccutive patients who were CABG operated at the Heart Institute HCM city, Viet Nam from Jan 2008 to July 2010.
Results : a total of 65 cases with total arterial revascularization (TAR) were performed. Mean age was 62 ± 9.2 and 33% were female . In study group, tripple vessel disease was 86% and left main disease was 19 cases. Before operation, 29% patients suffered unstable angina , mean left ventricle ejection fraction was 57.75 ± 11.2 % and mean left ventricle end diastolic diametre was 49.5 ± 5.7mm. Pre-operation we evaluated risk factor by EuroScore which was 2.5 ± 1.4 . Beside the gold standard graft LIMA to LAD (100%) , the radial artery was used in 63 cases (97%) and the RIMA was used in 32 cases ( 49%). Total anastomosis created by radial artery were 65 ( 4 sequential grafts ). No operative death and no myocardial infarction post-op. Mean time of follow-up was 14 ± 8.5 months. 31% patients were performed coroangiography or MSCT 64 after operation 6- 24 months.Patency rate of radial graft was 90% (18/20 ): 1 completed occlusion , 1 stenosis 90% ( or arterial spasm), 1 stenosis below 50% .
Conclusions: - using screening procedures before harvest the radial artery: modified Allen’s test arterial Doppler Finger saturation Lexer-Kenen-Henler ‘s test could be safely harvested the radial in almost patients under 65 y.o.
- with minor complications after radial harvested, easy technique and short –time harvesting the radial artery is the best second arterial graft for isolated CABG.
Key word : CABG : coronary artery bypass graft ; TAR : total arterial revascularization
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