In-hospital results of coronary artery bypass grafting with arterial conduits in patients with diffuse coronary artery lesion

Andreev AV, Akhmadov II, Shiryaev AA, et al. . In-hospital results of coronary artery bypass grafting with arterial conduits in patients with diffuse coronary artery lesion. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(2):135‑141. (In Russ.)
https://doi.org/10.17116/kardio202316021135

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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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 1^st 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 2^nd group from large-focal myocardial infarction. No mortality was observed in the 1^st 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.

Keywords:

coronary artery bypass grafting

diffuse lesion

radial arteries

coronary artery bypass grafting with arterial conduits

Authors:

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0003-0945-9400

Akhmadov I.I.

Chazov National Medical Research Centre of Cardiology

Shiryaev A.A.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-3325-9743

Vasiliev V.P.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-2297-6026

Galyautdinov D.M.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-3312-9447

Kurbanov S.K.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0001-7767-1695

Pashaev R.A.

Chazov National Medical Research Centre of Cardiology

Akchurin R.S.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-2105-8258

Received:

22.06.2022

Accepted:

20.08.2022

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