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Comparison of the radial artery and saphenous vein as composite grafts in off-pump coronary artery bypass grafting in elderly patients: a randomized controlled trial

Title
 Comparison of the radial artery and saphenous vein as composite grafts in off-pump coronary artery bypass grafting in elderly patients: a randomized controlled trial 
Authors
 Suk-Won Song ; Soon-Young Sul ; Kyung-Jong Yoo ; Hee-Jung Lee 
Issue Date
2012
Journal Title
 Korean Circulation Journal (순환기) 
ISSN
 1738-5520 
Citation
 Korean Circulation Journal (순환기), Vol.42(2) : 107~12, 2012 
Abstract
BACKGROUND AND OBJECTIVES: Arterial grafts have a better long-term patency rate than saphenous vein (SV) when used in off-pump coronary artery bypass surgery (OPCAB). However, arterial grafts in elderly patients are often diseased. We sought to compare the early outcomes achieved by using the two different types of composite grafts. SUBJECTS AND METHODS: We conducted a randomized trial to compare radial artery (RA) and SV composite grafts based on the in situ left internal mammary artery in 60 elderly (>70 years old) patients, who were scheduled to undergo OPCAB. Clinical outcomes and 1-year postoperative CT angiography results were compared. The quality of the conduit was evaluated by employing vascular ultrasonography, optical coherence tomography (OCT), and histologic examination. RESULTS: No differences in immediate postoperative morbidity and mortality were observed between the two groups. Early postoperative CT angiography revealed a SV patency rate of 100%, which was not different from that of RA composite grafts (99.1%). CT angiography after a year showed an overall patency rate of 96.3%. The overall patency rate of the SV group at 1 year was 94.7%, which was similar to that of the RA group (97.4%). Also, there was no difference in overall survival rate between the two groups. Vascular ultrasonographic images showed strong correlations between OCT and histopathology. CONCLUSION: Our analysis of early outcomes revealed that the SV could be used as an alternative composite graft to the RA in elderly patients. Vascular ultrasonography is an accurate, real-time, and reproducible method for assessing the quality of the RA conduit.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/91211
DOI
10.4070/kcj.2012.42.2.107
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Thoracic & Cardiovascular Surgery
Yonsei Authors
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