Long-Term Patency Rate of Radial Artery Conduits in Chinese Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
Long-Term Patency Rate of Radial Artery Conduits in Chinese Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
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DOI：
10.1536/ihj.18-305
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发表时间：
2019-11-01
影响因子：
1.5
通讯作者：
Wang, ChunSheng
中科院分区：
文献类型：
--
作者：
Ji, Qiang;Song, Kai;Wang, ChunSheng
对于冠状动脉旁路移植术(CABG)的远期通畅性，桡动脉(RA)管道是否优于大隐静脉(SV)移植物，专家们尚未达成共识。本研究旨在评估非体外循环冠状动脉旁路移植术中RA管道与SV管道的长期通畅性，并筛选长期RA移植物失败的独立预测因素。80岁的可移植三支血管疾病患者接受非急诊的原发治疗。对使用RA和SV两种导管的非体外循环冠状动脉搭桥术进行了综述。术后随访移植物通畅率、全因死亡率和重复血管重建术。确定了长期RA移植失败的独立预测因素。320名合格患者中共有296名(42名女性)。61.3例9.9岁)获得随访，观察期93.4±16.5个月。全因死亡率为14.5%，其中6例RA和9例SV再次血运重建。与SV相比，RA桥的通畅率更高(84.4%比78.5%，P=0.035)。预测长期RA移植失败的独立因素包括靶冠状动脉近端狭窄90%(OR=2.35，95%CI 1.41~5.82)和糖尿病(OR=1.66，95%CI 1.17~4.26)。RA移植远期通畅性优于SV移植。糖尿病患者或靶右冠状动脉近端狭窄患者的RA移植物的长期通畅性可能较差。
Consensus has yet to emerge among experts as to whether the radial artery (RA) conduit was superior to the saphenous vein (SV) graft for coronary artery bypass grafting (CABG) in terms of long-term patency. This study aimed to evaluate long-term patency of the RA conduit compared to the SV conduit for off-pump CABG, and to screen the independent predictors of long-term RA graft failure.Patients < 80 years of age with graftable triple-vessel disease undergoing non-emergent, primary. isolated off-pump CABG, using both the RA and the SV conduits, were reviewed. Graft patency, all-cause mortality and repeat revascularization were followed-up. The independent predictors of long-term RA graft failure were identified.A total of 296 out of 320 eligible patients (42 females. 61.3 t 9.9 years old) received follow-up with an observed period of 93.4 +/- 16.5 months. All-cause mortality was 14.5%, and repeat revascularization was conducted on 6 RA grafts and 9 SV grafts. Superior patency of the RA grafts compared to the SV grafts was observed (84.4% versus 78.5%, P = 0.035). Independent predictors of long-term RA graft failure included proximal stenosis of target right coronaries < 90% (OR = 2.35, 95%CI 1.41-5.82) and diabetes mellitus (OR = 1.66, 95%CI 1.17-4.26).The RA graft had a superior long-term patency than the SV graft. Long-term patency of the RA graft may be poor in diabetics or in the case of proximal stenosis of target right coronary