OBJECTIVE
To analyze the results of coronary artery bypass grafting with arterial conduits in patients with diffuse coronary artery lesion.
MATERIAL AND METHODS
A retrospective study included 257 patients with diffuse coronary artery lesion who underwent coronary artery bypass surgery between 04/01/2020 and 04/01/2022. In some patients, surgical treatment was performed using additional radial artery graft (n=87, group 1). In other ones, coronary artery bypass grafting was performed using the left internal mammary artery (IMA) and great saphenous vein (n=170, group 2). Right IMA was used individually in both groups. We applied propensity score matching to obtain comparable groups. There were 2 groups by 63 patients. Control angiography was performed after 7-10 postoperative days in 47 (37.3%) patients who signed an informed consent. We visualized 180 coronary bypass grafts including 89 arterial (left IMA — 47, right IMA — 14, radial artery graft — 28) and 91 venous grafts. Clinical and angiographic results were analyzed.
RESULTS
Clinical and demographic characteristics of both groups were comparable. Men prevailed (90.5 vs. 87.3%, respectively). Mean age of patients was similar (61.9±6.9 vs. 64.3±9.2 years, p=0.099). Time of aortic cross-clamping (64.3±14.3 vs. 64.5±17.7 min, p=0.938) and cardiopulmonary bypass (95.3±19.0 vs. 98.6±22.8 min, p=0.382) did not differ. Revascularization index was slightly higher in the 1st group (3.7±0.7 vs. 3.9±0.8, p=0.09). There were no significant differences in the incidence of perioperative myocardial infarction (0 vs. 1.6%, p=0.496). No strokes were detected. One patient died in the 2nd group from large-focal myocardial infarction. No mortality was observed in the 1st group. Angiography confirmed 100% patency of arterial grafts (89/89) and occlusion of 6.6% of venous grafts (6/91). Differences were significant (p=0.029).
CONCLUSION
Coronary artery bypass grafting with radial artery graft demonstrates satisfactory clinical results comparable to those after standard intervention in patients with diffuse coronary artery lesions.
