[Early and middle outcomes of total arterial revascularization using exclusively internal mammary artery and radial artery].

OBJECTIVE

To evaluate the early and mid-results of the use of the radial artery alongside the internal mammary artery for complete arterial revascularization in coronary bypass surgery.

METHODS

From January 1999 to January 2005, 123 patients with coronary artery disease with lesions in more than one branch (target vessel), 114 males and 9 females, aged 51.9 +/- 9.4 (32 approximately 74) underwent coronary artery surgery after the complete arterial revascularization pattern. Before the operation the left ventricular ejection fraction (EF) value ranged 30% approximately 78%, and 24 patients (21.1%) had poor ejection fraction (with the EF < 50%). Sixty-four patients (52%) had previous myocardial infarction. Four patients with unstable angina received urgent operation. 36 patients (29.3%) had disease of the left main trunk. 74% of the patients underwent off-pump bypass technique. The mean number of distal anastomoses was 2.6 +/- 0.4 per patient. 20 patients were followed up for 62 +/- 12.8 months (36 approximately 80 months).

RESULTS

The early mortality was 0.8%. Postoperative complications included arterial fibrillation in seven patients (5.7%). One patient underwent IABP insertion because of low cardiac output, 3 patients were re-admitted because of heart failure, angina and arrhythmias. Three patients died of cardiac events. One patient underwent redo-CABG due to recurrent myocardial infarction and one patient underwent percutaneous coronary intervention because of stenosis of the arterial graft.

CONCLUSIONS

Complete arterial revascularization using radial and mammary arteries provides excellent early results, showing a low mid-term complication rate and surgical morbidity.