BACKGROUND:
The complementary graft of choice to the right coronary artery (RCA) system in patients undergoing left-sided bilateral internal thoracic artery (BITA) grafting remains undetermined. Saphenous vein graft (SVG) was compared with radial artery (RA) as the supplemental conduit to the RCA when left-sided BITA grafting is implemented.
METHODS:
From 2006 to 2013, 652 patients underwent BITA grafting to the left coronary system with RA grafted to the distal RCA or posterior descending artery (RA group). They were compared with 163 patients with left-sided BITA in whom SVG was used for grafting the RCA system (SVG group).
RESULTS:
Female sex (15% versus 12%, p=0.23), diabetic patients (47% versus 42%, p=0.27), emergency cases (9% versus 5.5%, p=0.11), and left main coronary artery disease (26% versus 23%, p=0.35), were more prevalent in the SVG group. Number of grafts per patient was similar in both groups (4.4 versus 4.24, p = 0.125. Thirty-day mortality was 1.2% in the SVG and 0.6% in the RA group (P=0.46). Occurrence of perioperative complications (myocardial infarctions, strokes, bleeding, and sternal infections) was similar. Follow-up ranged from 12 to 84 months (median, 51 months). The 1, 3 and 8 -year survival was 99% , 97% and 95% in the RA group and 98% , 96% and 93% in the SVG group, respectively, (Kaplan-Meier) (p=0.21, Log-rank
CONCLUSIONS:
BITA grafting confers good long-term survival irrespective of the RCA conduit. The use of supplemental RA conduit is feasible and safe.
