Emir Mustafa, Kunt Ayşe Gül, Çiçek Murat, Bozok Şahin, Karakişi Sedat Ozan, Uğuz Emrah, Hidiroğlu Mete, Çetin Levent, Şener Erol
Department of Cardiovascular Surgery, Recep Tayyip Erdogan University Faculty of Medicine, Training and Research Hospital, Rize, Turkey.
Cardiovasc Revasc Med. 2012 Sep-Oct;13(5):272-6. doi: 10.1016/j.carrev.2012.07.003. Epub 2012 Aug 11.
This study was undertaken to compare early postoperative results, programmed multi-detector row computed tomography coronary angiographic patency and midterm results of revascularization by sequential radial artery grafting with those of single radial artery grafting during a five-year period. Patients were grouped as those with sequential radial artery grafts (Group A, n = 27) and single radial artery grafts (Group B, n = 26). Multi-detector row computed tomography coronary angiography was scheduled at 1 and 5 years postoperatively. Each distal anastomosis was accepted as nonfunctional if a radial artery graft was occluded proximally or there was a critical stenosis. One sequential radial artery graft and two single radial artery grafts failed in the 1-year period (p>0.05). In the 5-year period, three radial artery grafts failed in each group (p>0.05). In Group A, there was no mortality in the five-year period, but in Group B, one patient died four years after the operation due to cardiac problems (p>0.05). In addition to one death in Group B, there were three percutaneous interventions and two myocardial infarctions among the 26 patients during the five-year follow-up. In group A, among 27 patients, there were 4 percutaneous interventions and one myocardial infarction (p>0.05). Although the sample size is relatively small to be conclusive, these data suggest that sequential radial artery grafting may be considered as a method of choice for maximizing arterial graft survival and patency. Noninvasive control of sequential and single radial artery grafts with multi-detector row computed tomography is feasible with no discomfort for the patient and excellent visualization of grafts.
本研究旨在比较连续桡动脉搭桥与单根桡动脉搭桥在五年期间的术后早期结果、多排螺旋计算机断层扫描冠状动脉造影显示的血管通畅情况以及血运重建的中期结果。患者分为连续桡动脉搭桥组（A组，n = 27）和单根桡动脉搭桥组（B组，n = 26）。术后1年和5年安排多排螺旋计算机断层扫描冠状动脉造影。如果桡动脉搭桥近端闭塞或存在严重狭窄，则每个远端吻合口被视为无功能。1年内，1例连续桡动脉搭桥和2例单根桡动脉搭桥失败（p>0.05）。在5年期间，每组有3例桡动脉搭桥失败（p>0.05）。A组在五年期间无死亡病例，但B组有1例患者在术后四年因心脏问题死亡（p>0.05）。除B组有1例死亡外，在五年随访期间，26例患者中有3例接受了经皮介入治疗，2例发生心肌梗死。在A组的27例患者中，有4例接受了经皮介入治疗，1例发生心肌梗死（p>0.05）。尽管样本量相对较小，不足以得出确凿结论，但这些数据表明，连续桡动脉搭桥可被视为使动脉搭桥存活和通畅最大化的一种选择方法。用多排螺旋计算机断层扫描对连续和单根桡动脉搭桥进行无创控制是可行的，患者无不适，且搭桥显示极佳。
