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Sequential Radial Artery Grafting Three-Vessel Coronary Artery Disease

Esat Aknc, MD, Vedat Erentug, MD, Kemal Uzun, MD, Adil Polat, MD, Deniz Göksedef, MD, Cevat Yakut, MD

Kouyolu Heart and Research Hospital, Istanbul, Turkey

For reprint information contact: Vedat Erentug, MD Tel: 90 216 326 6969 Fax: 90 216 339 0441 Email: drvedat2002{at}yahoo.com, Ulus Vadi Konutlari A1/9, Ortakoy, 80840 Besiktas, stanbul, Turkey

Our objective was to compare the results of revascularization by sequential radial artery (RA) grafting with a left anterior descending left internal mammary artery (LIMA)-RA t-composite grafting technique. Patients were grouped as those with proximal anastomoses performed on the ascending aorta (Group A; n = 38), and those with proximal anastomoses performed on the LIMA as t-grafts (Group T; n = 13). Neither of the two groups revealed any mortality. The average number of grafts was lower in Group T (2.23 ± 0.43 in group T and 2.85 ± 0.69 in group A, p < 0.05). The results of the control coronary artery angiographies were superior in Group A. The patency rate of the RA grafts was 96.8% in Group A. Of the 20 distal anastomoses performed with RA grafts in 8 patients from Group T, nine (45%) were found to be patent. The patency rates of RA grafts with sequential distal anastomoses were found to be better when the proximal anastomosis was performed on the ascending aorta rather than on the LIMA. In conclusion, sequential distal anastomosis of RA grafts seem to be safe and effective when proximal anastomoses are performed on the ascending aorta.