Early Outcomes of Using Radial Artery in Coronary Artery Bypass Surgery in Cairo University Hospitals

Abstract

Background: Using arterial grafts is commonly associated with good outcome. Using left internal mammary artery and radial artery can achieve complete arterial revascularization of left coronary system by using sequential grafting or multiple Y Technique. Objective: We present our experience in using internal mammary artery and radial artery (RA) Y-graft in 100 patients. Patients and Methods: Between February 2016 and January 2019, 100 patients (aged 45-60 years) with the diagnosis of multi-vessel disease underwent complete arterial revascularization using left internal mammary artery (LIMA) and RA. We used the technique of RA (Y) or (T) graft on LIMA to revascularize left coronary system; we did multiple (Y) or (T) graft or sequential grafts. Results The operating time was 220±20 minutes in average, the bypass time was (92.5 ± 16.7) minutes, and cross-clamp time was (70.6 ± 20.6 minutes). LIMA was anastomosed to the left anterior descending coronary artery (LAD) system in all patients. RA Y-graft was anastomosed to LIMA in all patients. Sequential grating using RA was done in 20 patients. The mean ICU stay of the patients was (2.2 ± 0.5 days). Mean hours of mechanical ventilation was (14.3 ± 2.9). Four patients required re-exploration for bleeding. 66 patients needed blood transfusion. 45 patients required inotropes. Conclusions: RA can be used safely with LIMA to revascularize left coronary territory using sequential grafts or multiple (Y) grafts. This method allows for complete arterial grafting in multi-vessel disease using only single IMA and RA grafts with good early results.